In addition to clinical advocacy, new claims advocacy service helps consumers through their entire health care journey
PEMBROKE, Mass., March 26, 2018 /PRNewswire/ — ConsumerMedical, a leading health care advocacy, decision support, and expert second opinion company, has enhanced its Ally Medical Decision Support platform to now assist employees with resolving issues with their medical bills. The Claims Advocacy service is offered in addition to ConsumerMedical’s traditional clinical advocacy support to help consumers throughout their entire health care journey.
“This is an important piece of the comprehensive support we offer,” explains David Hines, CEO and Founder of ConsumerMedical. “When you are facing an illness the last thing you have energy for is trying to figure out a confusing medical bill, or a bill that may be incorrect, or a claim that is denied. We help relieve individuals of this burden, so they can focus on getting well and not paperwork. And if they are getting back to work, we free them up of this burden so they can focus on their job.”
According to a recent Employer Benefits News article, medical claims errors can easily be as high as 2% to 5% of total claim within an employer’s self-insured health plan. In a high deductible health plan environment, the employee is often financially responsible for these errors and often isn’t equipped to resolve the issue. ConsumerMedical’s Claims Advocacy service can help employees identify and resolve these billing errors, assist with their health plan’s appeal process, and also help employees simply understand their benefits, including coverage limitations.
According to an AIR Health Insurance Literacy Survey, while 75 percent of consumers feel confident they know how to use their health insurance, only 20 percent can accurately calculate their out-of-pocket costs.
“Health care coverage is a very confusing topic,” explains Hines. “For example, while it is great that preventive care like a mammogram is now covered under the ACA, preventive care can often turn into diagnostic care, presenting consumers with a confusing bill. We also find many consumers are confused by their deductible, which isn’t the same as the deductible for their car insurance, a concept they are often more familiar with.”
In most cases, employees who contact ConsumerMedical for assistance with medical bills have already been using ConsumerMedical for clinical advocacy support, such as assistance understanding a new diagnosis or their treatment options.
“Our goal is to really build trust and support the patient and family throughout their entire health care journey,” says Hines.
About ConsumerMedical – ConsumerMedical is a leading health care advocacy, decision support and expert second opinion company serving over 2.5 million individuals through some of the nation’s largest employers, health plans and private exchanges. The company has been serving patients and payers for over 21 years. As a Medical Ally, ConsumerMedical guides participants throughout their health care journey with compassionate, high-touch support and deep clinical expertise. ConsumerMedical offers a fully integrated suite of solutions including Medical Decision Support, Surgery Decision Support, Expert Medical Opinion, Claims Advocacy and more, helping individuals and families navigate the health care system while improving outcomes and reducing costs. ConsumerMedical’s results have been validated continuously by independent actuaries. More information is available at www.consumermedical.com.