advocacy
June 14, 2023
Advocacy in Action | In Network Status for Inpatient Treatment
Imagine, your child is having severe mental health issues. You can’t help so you have to send them to an inpatient facility to get the help that they need and deserve. Then, the facility claims to be out of network. Claims are being denied and the facility tries to bill you thousands of dollars ...
May 23, 2023
Advocacy in Action | Scheduling Assistance
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 benefits program. They can assist with concerns about claims, patient referrals, balance bills, enrollment delays, or any benefits issue. ...
April 25, 2023
Advocacy in Action | Prescription Drug Claims
A member’s husband was taking 4 different prescription 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 ...
March 15, 2023
Advocacy in Action | Assistance Reprocessing Claims
A member called into Purple Card because he had a $570 Urgent Care bill go to collections. He did not believe he owed the amount to the Urgent Care facility. The Patient Advocate reviewed the bill and contacted the insurance carrier to determine why the claim paid the way it paid and why the ...
February 16, 2023
Advocacy in Action | Hospital Bill Assistance
A member was hospitalized and received a provider bill for medical supplies totaling $3,137.75 and an explanation of benefits from the insurance carrier showing a member responsibility of $64,398.00 for the hospital bill. The member knew he had already satisfied the plan’s $1,500 in-network ...
January 18, 2023
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 ...
December 7, 2022
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 ...
November 15, 2022
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 ...
October 19, 2022
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.) ...
September 14, 2022
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 ...
