advocacy

Advocacy in Action | Prescription Appeal Assistance

A member was having a problem filling a brand name prescription medication she had been taking for the last 4 years. A formulary pharmacy benefit change had been made to the insurance plan and the cost of the brand name prescription medication had risen several hundred dollars. Because of the ...

Advocacy in Action | Recovering Claims Denied as Work-Related

After being injured in a hunting accident, a member began to receive outstanding invoices for over $88,000 in unpaid claims. The Member reached out to The Purple Card to inquire why these claims were not paid, stating that they should have met their deductible. At first the claims were pending ...

Ready to Face COVID-19 Together | A Message from our CEO

Dear Brinson’s family of clients and friends, As we all navigate our response to the Coronavirus Disease 2019 (COVID-19) and these challenging times together, our heart of advocacy is alive and well and extends to the safety and well-being of you, your employees and our own teams. I couldn’t be ...

Prevention & Treatment of the Coronavirus

There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to prevent illness is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory diseases, including: Avoid ...

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 ...

Advocacy in Action | Updating Insurance Cards and Recovering Claims

A member called into Purple Card because she had received a bill for $4,138.75. She believed she did not owe this amount to the facility because her insurance plan should have paid some if not all of the amount. The Patient Advocate reviewed the bill and contacted the provider’s billing office ...

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 ...

Advocacy in Action | New Coverage Call Ahead Assistance

A member’s medical coverage was being changed from one plan to another and the carrier’s system was not yet updated to reflect the new benefits or eligibility information.  The member had several scheduled appointments for tests and procedures and needed the help of their Patient Advocate to ...

Advocacy in Action | Labor and Delivery Bills

A member contacted her Patient Advocate to request an audit of delivery bills for her newborn baby. The Patient Advocate reviewed the EOB’s and discovered that the insurance carrier had over-applied her deductible. It appeared that the member had met her deductible and out of pocket expenses of ...

Advocacy in Action | Prescription Drug Claims

A member’s husband was taking 4 different prescriptions on medications each month. The upfront cost seemed to be much more than the member felt they should pay under their insurance plan. The member contacted Purple Card for assistance and asked them to check into what was going on with the ...