Advocacy in Action | Auditing Claims and Facilitating Refunds

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

Janel contacted the provider’s office and spoke with the billing department regarding the overpayment. The billing department confirmed the member was due credit and saw she had a follow-up appointment scheduled the very next day. They told Janel if the member would bring her credit card with her, they would reverse the overpayment and credit the amount back onto her card.

The member really appreciated Janel’s help and shared these words of praise:

“I was quite excited to get a refund back on my credit card…could not have done it without your help. Thank you so much!“

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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 benefits programs. We not only assist our members, but we also educate them on ways to maximize health care coverage and other available benefit programs.