advocacy

Advocacy in Action | Negotiating Unexpected Claims

Provider Balance Bill 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, ...

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 ...

Advocacy in Action | 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 | Unexpected Bill

A member received a bill from the lab for $2,152.89. The member did not understand why she was receiving the bill and mentioned the issue to her co-worker. Her co-worker mentioned her Patient Advocate had helped her resolve a similar issue. The member called her Patient Advocate about the lab ...

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 | Claims Assistance

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 | Dental Bill Assistance

A member contacted Purple Card about a billing and refund issue she was having with a dental office.  Her husband had received dental treatment and services.  At the time of the visit, the dental provider asked him to pay $433 for the services.  The dental office filed the claim with the dental ...

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 | 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 | Claims Assistance with Emergency Room Bills

A member received two bills from an emergency room service provider totaling $844.  One bill was for the emergency room facility charges and the other was for the emergency room physician.  The member did not know what to do and contacted Purple Card for assistance.  Her Patient Advocate ...