advocacy

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 ...

Pharmacy Fraud Alert: Don’t Fall for Inflated Prescription Costs

Take a minute to put yourself in the shoes of Dave Jensen. According to NBC News, the 46-year-old firefighter went to his pharmacy to fill a prescription for antibiotics, paying more than $70 through his health insurance – only to realize later that he’d paid twice as much as he would ...

Advocacy in Action | Assistance with Anesthesia Balance Bill

A member’s daughter had a history of seizures and her pediatric neurologist recommended an MRI be completed.  Due to the child’s young age, sedation was required to perform the testing.  The MRI testing was arranged and scheduled at an In-Network hospital.  The testing was performed by ...

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 ...
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