Advocacy in Action | Dental Bill Assistance
A member contacted Purple Card about a billing and refund issue she was having with a dental office. Her husband had received dental treatment and services. At the time of the visit, the dental provider asked him to pay $433 for the services. The dental office filed the claim with the dental carrier and once the claim processed, the explanation of benefits showed he only owed $118 to the service provider and not $433. The member contacted the dental provider for a refund of $315. The dental office told her they left off a $150 charge for lab services and the member owed them the additional money. The member was not sure what to do as the service provider was asking the member to pay this amount without first filing a dental claim for the lab services to see if any of the amounts might be covered by the dental plan. The member was frustrated with the dental office for not filing the lab charge, so she contacted her Patient Advocate. The Patient Advocate contacted the dental office on behalf of the member and asked them to file a claim for the lab charges. The dental office filed the claim and once processed, the lab fees were not covered. The Patient Advocate then checked to see if the member’s medical plan might cover the lab fees but the medical plan only covered dental services related to an accident or injury. The Patient Advocate let the member know the lab fee was not covered by either the dental or medical plans and the dental office would be sending a refund for $165. The member was grateful for the help she received from her Patient Advocate and sent a note stating:
“We received the check yesterday! Thank you for all of your hard work on getting the issue resolved.”
At Brinson Benefits, we care about the patient’s best interest. We believe the patient should have an available healthcare navigator and advocate. Our Patient Advocates at The Purple Card® are highly trained to educate members about available benefit programs. They work hard to resolve issues with providers and insurers.
The Purple Card® is an independent health care advocacy and assistance service. Our Patient Advocates provide time and cost-saving services to resolve concerns about benefits programs. We not only assist our members, but we also educate them on ways to maximize health care coverage and other available benefit programs.
