Ask what “success” means, when it was measured, who was included, how many people were included, how people lost to follow-up were handled, and whether an independent party reviewed the result. Ask whether the number applies to the specific legal entity, address, service, and time period you are evaluating. If those answers are unavailable, mark the claim “not established,” even if the percentage is precise.
Coverage requires its own evidence trail. Ask the facility what information it submits and what costs it expects you to pay, but confirm benefits with the insurer using the legal entity, location, requested service, and anticipated date. Ask about network status, authorization, deductibles, coinsurance, exclusions, and whether quoted amounts are estimates. An eligibility check, accepted insurance card, or insurer logo does not guarantee authorization, payment, or the final balance.
- Request the written method behind every outcome percentage.
- Write down insurer and facility reference numbers separately.
- Mark payment and personal cost as “needs review” until the relevant parties issue specific determinations.