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Advocacy
Healthcare is complicated, by design. The healthcare industry makes it that way.
Health Advocacy is a service for consumers and their families to get assistance with their healthcare.
Real Life Examples
Outpatient Surgery
Member required care at an out-of-network ambulatory surgery center.
Resolution: negotiation saved significant amounts off usual charges. Plus, the provider agreed to accept lower fees & not balance bill the member or the plan.
Billed Charges: $60,715 – Negotiated Amount: $40,072 = 34% Savings ($20,643)
Required Imaging
Needed an MRI & 2 ultrasound. Her doctor referred her to an imaging center that would cost $800.
Resolution: The member asked her Advocate if this was the best option and he found estimates with 2 other local in-network centers for $600 or $950.
Original Cost: $800 – Selected Cost: $600 = 25% Savings ($200)
Surprise Anesthesia
Following surgery, an employee received a large bill from a non-participating anesthesia group.
Resolution: The Advocate negotiated an arrangement that reduced the member’s responsibility.
Billed Charges: $3,275 – Negotiated Amount: $2,030 = 38% Savings ($1,245)