Advocacy in Action | Lab Work Claims

Our Patient Advocates are serious about service. As an independent resource, they are available to our members to help them resolve any concerns about their benefit program.  They can assist with concerns about claims, patient referrals, balance bills, enrollment delays, or any benefits issue.

How The Purple Card® was able to assist…

A member contacted The Purple Card® stating that she had some blood work performed and had received several large bills showing she owed out-of-pocket amounts totaling almost $1,800. The member felt the charges were far too high and believed she did not owe any of these amounts. She asked her Patient Advocate to research the lab bills and let her know what she found.

When the Patient Advocate reviewed the billed amounts, she found the providers were billing the member for the full amount of the lab work. The billed amounts the member received did not reflect the insurance carriers claim payments. Once the claims for the lab work were processed by the carrier, they were paid at 100%.

When completing the review of the bills, the Patient Advocate found three out of the four bills had been sent to the correct insurance carrier and had been processed correctly. However, a fourth bill in the amount of $323.40, was sent to an incorrect insurance carrier and had not been paid. The Patient Advocate called the lab regarding the bill and provided correct insurance billing information so they could file the claim with the right carrier.

Once the claim was processed, the member did not owe anything on this bill either. Here is what the member had to say about the services she received from The Purple Card®:

“Your service is so awesome, I knew something was wrong. Thank you so much and my day is now wonderful, thanks to 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 benefit programs. We not only assist our members, we educate them on ways to maximize health care coverage and other available benefit programs.