advocacy

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 ...

Advocacy in Action | Large Hospital Bill Assistance

A member’s wife had incurred large hospital and treatment bills totaling over $75,000. The member wanted to make sure the claims had been processed and paid correctly by the carrier and the balance due amounts being billed by the service providers were valid and should be paid. The member knew ...

Advocacy in Action | Home Health Services

A member was being billed over $4,000 for home health services. The member was very upset as he did not have money to pay the charges. He called The Purple Card® to see what they could do to help. The Patient Advocate contacted the home health service provider and the carrier’s claim department ...

Advocacy in Action | HRA Reimbursement

A member desperately needed surgery and was very concerned because the surgical center was requesting a $2,000 upfront payment. The member had no idea how he was going to come up with the money on such short notice. He called The Purple Card® for help.  The member’s insurance plan had a $5,000 ...

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. ...