advocacy

advocacy

Advocacy in Action | Reprocessed Claims Assistance

A member contacted Purple Card because she had received another bill from her medical provider for charges dating back to a year prior. The member sent a copy of the bill and asked her Patient Advocate to check and see why the provider was still sending her a bill. The Patient Advocate checked ...

Advocacy in Action | Auditing Claims and Facilitating Refunds

A member contacted his Patient Advocate to request an audit of his eye surgery claims. He felt he might have paid the doctors too much. The Patient Advocate reviewed the bills and EOB’s and discovered that the member had definitely overpaid the surgeon by over $800. The Patient Advocate ...

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 ...

Advocacy in Action | Benefit Education

A member contacted The Purple Card for assistance. He had primary coverage through his employer’s BCBS plan and secondary coverage with Medicare Part A only, no Part B (Part A covers inpatient hospital care and Part B covers items such as outpatient services, laboratory tests, x-rays, etc.) ...

Advocacy in Action | Hospital Delivery Claims Investigation

A member contacted her Patient Advocate to request an audit of delivery bills for her newborn baby. The PA 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 $3,125.00 on ...

Advocacy in Action | Specialty Pharmacy Prescription Drug

A member’s daughter has a chronic illness and needed help obtaining a special prescription drug to treat the condition. The child had been taking another prescription drug but had experienced an adverse reaction causing the child to be hospitalized. The member needed the daughter’s new ...

Advocacy in Action | Preventative vs. Diagnostic Claims

A member contacted her Patient Advocate to find out why she was being billed $753.00 for her routine preventative colonoscopy. This was the first time she had ever had a colonoscopy and her doctor told her it was a preventative test. She told her Patient Advocate she had just lost her mother ...

Advocacy in Action | Health Reimbursement Arrangement (HRA) Education

A member contacted Purple Card upset about a large amount of out-of-pocket money he owed the service provider for his emergency room visit. His Patient Advocate listened to the member and then reviewed the member’s emergency room claims and his coverage. She saw the member had selected a high ...

Advocacy in Action | Assistance with Special Neurological Testing

A member contacted Purple Card because his son’s neurologist ordered a special neurological test and the insurance carrier had been delaying approval for over six months. The member was at his wit’s end and contacted Purple Card to see if they could help. The Patient Advocate visited with ...

Advocacy in Action | Collections Correction

brinson-benefits-Advocacy-in-Action-Collections-Correction
Imagine, it’s the holiday season, you’re having a regular day and going about your business like normal. You check your mail and instead of opening Christmas cards, you find yourself opening a collection notice saying you owe almost $5,700 but they are willing to settle for less. This is the ...

Brinson Benefits