Advocacy in Action | Investigation of Balance Bill

A member contacted Purple Card for assistance. He had received bills from a service provider totaling $5,712 for medical services. He was concerned the claim had not been processed correctly by the insurance carrier and wanted to know if he truly owed over $5,000. The Patient advocate went to work and first checked with the insurance carrier to make sure the claims processed correctly. She found they were not processed correctly. The claims were sent back to the Claim Department for review and further processing. Once the claims had been reprocessed and additional payments had been made to the service provider, the Patient Advocate contacted the service provider to discuss the large balance bill the member was still receiving. The service provider found a glitch in their billing system which automatically billed the patient for any balance bill amount showing in their system. The provider’s office billing specialist worked with the Patient Advocate to apply all of the insurance payments and adjusted the patient’s bill manually. The member’s responsibility had been reduced from $5,712 to $206.22. The member was very pleased with the outcome and made this statement regarding the service received from The Purple Card®.

“We are so fortunate to have you working with us. Thank you!”

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.