Advocacy in Action | Recovering Claims Sent to Collections
A member had a preventative colonoscopy. All of his claims processed as preventative at 100% with the exception of the lab charges. The lab sent the member a bill for $730. The member contacted Purple Card for help. Our Patient Advocate reviewed the claims and then contacted the lab to make them aware the colonoscopy was preventative and the claim needed to be resubmitted. The lab was unwilling to resubmit the claim as they had already sent the $730 billed amount over to a collection agency. Our Patient Advocate then contacted the collection agency to request that they have the claim resubmitted to the carrier as preventative and place the member’s collection account on a 30 day hold. The Patient Advocate provided proof to the collection agency that all of the other claims related to the colonoscopy were processed as preventative. Once this was done, the collection agency had the claim resubmitted to the carrier as preventative. The carrier then reprocessed the claim at 100%. This saved the member $730.00. This is what the member had to say about the services received from The Purple Card®:
“That’s why I have YOU and the Purple Card!!!! I love this service!”
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.
