How You Benefit
A valuable feature of the HealthFlex program is access to the services of a Patient Advocate. Patient Advocacy gives you an array of value-added services. Your personal Patient Advocate can help:
- Save you considerable time and money.
- Eliminate the hassles and frustrations typically encountered when dealing with the healthcare system.
- Assist you in finding doctors, hospitals and other healthcare providers.
- Protect your privacy and confidentiality.
- Facilitate access to medical centers.
- Cut through the red tape and effectively solve problems.
Personal Patient Advocates are a trained administrative team. When you call for assistance, you will be assigned a personal Patient Advocate who will take responsibility for helping you. The Patient Advocate team does the legwork. The team makes the phone calls and assists in making all of the necessary arrangements. Simply put, Patient Advocates help to make sure that you get the most from your healthcare experience.
Depending on life circumstances, people seek expert counsel on a range of health needs. The Patient Advocacy service will help you identify medical institutions and providers throughout the country to assist you in meeting your complex medical needs.
For more routine needs, the provider locator service will help you identify physicians and institutions anywhere in the country. This service is especially valuable for individuals who need a new doctor, travel often or are relocating to a new community.
Dealing with healthcare bills, payment arrangements and related administrative issues is no simple task. It is time-consuming and it can be costly if you don't know how to navigate the health and insurance systems. Your personal Patient Advocate will help sort out and solve these complex issues for you. He or she works through administrative issues, assists with benefit denials and helps negotiate billing overcharges. Your Patient Advocate also provides advice or assistance to you when filing a complaint or grievance with your insurer. The program offers you the confidence that you have a strong knowledgeable advocate in your corner at all times.
Your personal Patient Advocate helps guide you in selecting services that best meet your needs. He or she will also help arrange for necessary services with third-party vendors to meet your personal schedule.
Members are responsible for payment to physicians, hospitals, and other health care or service providers. Your Patient Advocate will always review your options with you in advance of contracting with a third-party provider.
Your Patient Advocate is not a trained or licensed physician, nurse or other medical provider. Your Patient Advocate can help you with the following administrative tasks:
- Helps find physicians, hospitals, dentists, and related healthcare providers
- Verifies network participation
- Coordinates medical record transfers
- Provides nationwide service
- Fee Negotiator
- Assistance locating Grievance Counselors
- Complementary and Alternative Medicine: assistance with locating acupuncture, chiropractic care and massage therapy services.
How To Use The Patient Advocacy Service
Simply call the Member Services number on your Member ID Card to be transferred to one of the personal Patient Advocates who will help you.
It is important to note that the Patient Advocacy service does not provide health insurance or medical care, nor does it recommend treatment. The service is not a substitute for your current health insurance plan.
Patient Advocacy fully respects and protects the privacy of HealthFlex Limited Benefits Plan members and the confidentiality of their medical information.
Examples Of How Patient Advocacy Can Help You!
The following are examples of how the Patient Advocacy service helped members! These are actual examples of discount and services provided with the assistance of the Patient Advocacy service. Not all providers are willing to provide discounts and we do not guarantee that we will successfully be able to assist Members with requests for assistance. We recommend that, if at all possible, you discuss the costs associated with any healthcare with the provider prior to the service or treatment and that you contact Patient Advocacy prior to receiving any service or treatment in order to receive the best results. However, in the event of an emergency, immediately call 911 or go to the nearest emergency room.
August 22nd, 2005*
Patient Advocacy negotiated a 40%* discount on a Member’s medical bill. The balance was negotiated down from $1,302.00 to $781.20 (saving the member $520.80) and the Member will be able pay the discounted balance off by making a monthly payment of $25.00.
EULESS, TX
August 16th, 2005*
Patient Advocacy negotiated a 71.4%* discount for a Member’s ultrasound. The normal charge for an ultrasound is $175.00. The negotiated fee for the Member is $50.00 if she pays in full at the time of service.
ROME, NY
August 8th, 2005*
Patient Advocacy negotiated a 50%* discount off a bill for $3,350.00 (saving the Member $1,675.00). Plus, the provider agreed to allow the Member to make 6 month payments to pay off the balance if she would pay $502.50 at the time of service.
VICTORIA, TX
August 5th, 2005*
A Member needed assistance with medical bills related to a heart attack. Patient Advocacy contacted the healthcare provider and successfully arranged a payment plan of $50 to $100 for 6 months for the Member. If the Member makes the payments on time for 6 months, the healthcare provider will discount the $8,235.00 bill by 50%* (saving the Member $4,117.50). The healthcare provider also offered the option of providing the Member the 50%* discount if he paid the balance in full at the time of service.
GOLDEN, CO
August 3rd, 2005*
The Patient Advocacy service was able to negotiate a 35%* cash discount (if she pays in full at the time of service) for a Member whose provider was not a participating provider.
DUFFIELD, VA
August 3rd, 2005*
One of our Members was pregnant and was looking for help to reduce the healthcare costs associated with the delivery of her baby. We were able to negotiate a discount of 40%* if the bill is paid at the time of service. This discount will save the Member $2,420.00!
SNELLVILLE, GA
August 2nd, 2005*
A Member called asking for help negotiating a discount with his doctor. The bill was for $378. Patient Advocacy negotiated a
47%* discount, saving the Member $178. The provider also agreed to a 6 month payment plan as long as the Member paid the balance prior to his next appointment.
EDGEWATER, NJ
*These savings may not be typical and will vary by provider and location of service.
