We were introduced to Tracy through her insurance broker. Tracy owns and operates an international family business, has four children (two sets of twins), all under the age of 12 and one child is disabled. Tracy and her family live in New Jersey, but most of her doctors are in New York and many do not accept insurance, which means they need to file claims to get reimbursed for their payments. Over the years, Tracy has trained administrative assistants to take care of filing the claims, but her staff was unfamiliar with the claims management processes. When Tracy’s broker learned about Healthcare Pathfinder’s services, she was very excited to introduce us to Tracy. After we met Tracy, she was so relieved to know that she didn’t have to train another person and excited to pass along six months of unfiled claims.
Here is what Healthcare Pathfinder (HCP) did :
- Reviewed the current insurance coverage.
- Obtained a list of their medical providers and prescriptions.
- Obtained and filed release of information authorizations for the entire family for all medical providers and insurance companies, so that we could represent Tracy’s family.
- Logged onto her current insurance website to analyze how she utilized her current insurance coverage.
- Determined what providers are in and out-of-network.
- Filed all outstanding claims with the appropriate insurance companies.
- Developed a claims management spreadsheet to clearly keep track of all expenses, reimbursements and provide follow up.
- Proactively involved in obtaining prior authorizations for medical services.
HCP continues to manage the family’s claims. Since the authorizations are on file with their health insurance companies and medical providers, we are able to be proactive and advocate on their behalf. Tracy and her husband are so relieved to hand all of this off to professionals and know it is done correctly! Creating Peace of Mind!
*We have changed our clients’ names in our stories.*
Contact Healthcare Pathfinder at 888-511-0128, ext. 104, or view our website for more information: www.healthcarepathfinder.com