Advocacy in Action | Requiring Proof for Denied Claims
A member contacted her Patient Advocate for help with 4 bills being denied by the insurance
carrier as not covered under the plan. The Patient Advocate reviewed the bills and plan details and then contacted the insurance carrier to find out why they were denying coverage. The carrier told the Patient Advocate the claim payment denial was based on the contract language contained in the plan. When the Patient Advocate asked the carrier to send the specific language used to deny the benefit payment, the carrier could not provide the specific language. The claims were processed and paid. The member went from owing $4,369 to owing only $130. She saved $4,239. This is what the member had to say about the services received from The Purple Card®:
“Oh My Goodness, GOD is good all the time! Thank you, thank you, 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 benefit programs. We not only assist our members, we educate them on ways to maximize health care coverage and other available benefit programs.
