Vail Daily column: Finding the right doctor | VailDaily.com

Vail Daily column: Finding the right doctor

Judson Haims
My View

Choosing a primary doctor or medical specialist is not always the easiest thing to do. Add to this the ever-changing insurance requirements and the task can become tedious and overwhelming.

Building a longterm relationship with a primary care physician is a great first step in assuring yourself you will be provided excellent health care. Establishing a relationship with a medical provider who knows your medical background and understands what’s important to you is a must.

Discussing your health issues is a very personal experience. It’s important that you are comfortable talking to your physician about medical situations that arise. So before you start to narrow down your list, you may want to consider whether you prefer a male or female physician.

Another factor to consider is if the medical provider accepts your health insurance. While many of the medical providers that offer services within Eagle and Garfield counties accept most major health plans, you will want to check to make certain that your medical provider is on the list of providers approved by your insurance plan. When your medical needs require a specialist, confirming that the insurance company will pay for their services is imperative.

Don’t assume that because your insurance company pays for your local primary care physician that they will automatically pay for a local specialist. If you have an HMO plan, you will need to obtain a referral or authorization from your primary care physician before scheduling a visit with a specialist.

FINDING A PRIMARY CARE Doctor

United Healthcare provides the following suggestions to aid people who are looking for a primary care physician:

• Ask for referrals from friends and family. Then check to see if those doctors are in your plan’s network.

• Search your plan’s network for doctors whose locations are convenient for you and your family.

• Research the doctor’s education, certification and performance history. (Websites like abms.org and ama-assn.org are great resources for this.) Also, check your health plan to see which doctors have been specially designated for quality.

• Call the doctors on your list to find out more information about things like cancellation and payment policies, insurance claims and after-hour health concerns.

• Find out who covers for your doctor when he or she is not available.

• Schedule an appointment with your top choice to go over your medical history, discuss your health concerns and determine if it’s a good fit.

LOOKING FOR SPECIALISTS

Next, research medical professionals and hospitals that are specialists in your ailment(s). While we have many types of medical provider here in our valley, we simply do not have the variety found in a city.

Here are some questions you may want to ask of a prospective medical specialist:

• Are they board-certified?

• Will access to the specialist be difficult?

• How many similar cases has the physician treated during the past year?

• What is the specialist’s success rate in treating patients with your condition?

• How many days per week does the physician see patients?

• How do you reach them in an emergency?

• Who takes care of patients after hours and when the physician is gone?

• Is your insurance plan accepted?

• To which hospital(s) does the specialist have admitting privileges?

Regardless of age, knowing where to look for medical professionals that can provide the care you need is important. Don’t wait for an emergency to present itself before you educate yourself of where to seek the help you need.

Judson Haims is the owner of Visiting Angels Home Care in Eagle County. Contact him at http://www.visitingangels.com/comtns or 970-328-5526