Employee Advocacy Services

Advocacy membership entitles you, or your employees, to access to all the services listed below:

  • Physician Referral Service
  • Insurance Disputes Services (fight for payment - insurance appeals & grievances)
  • Medical Bill Auditing and Disputes Service
  • Cost Navigator (lower cost procedures)
  • Rx Price Comparison
  • Medical Research
  • Prescription, Dental and Vision Plans
  • The Health Counselor (a life coach for your medical needs)
  • Bills And Forms Consolidation Services
  • Elder Care Services
  • Nursing Home, Assisted Living & Hospice Services
  • Health Plan Review & Assessment
  • Selecting A Health Plan Booklet
  • Preparing For Your Hospitalization Booklet
  • There are more services listed for members in the "members area"

Healthcare isn't as simple as it used to be. And getting the best care is getting more difficult. Wouldn't it be nice to have a friend who knows the ins and outs of the healthcare system? When you're a member of Advocacy, you do.

Advocacy Services bring together the talent of doctors, nurses, lawyers, insurance specialists, social workers and healthcare policy and ethics professionals to make sure members get the best healthcare possible. Working as a team, Advocacy professionals see to it that your health insurance works the way it's supposed to. We'll work closely with you and your healthcare insurance company to resolve issues quickly.

The Benefits of

Membership

As a member, whenever you or your loved ones need help, our advocacy service will be there for you. When you have medical questions, insurance disputes, questions about coverage, even if you've been denied access for a certain medical procedure, we can help. We've combined the strengths of our experts to offer members such valuable services as medical research, insurance dispute resolution, bills and forms consolidation services, health counselors and more.

We've also put together a unique package of information that covers everything from choosing the best healthcare plan to preparing for your hospitalization to your rights as a patient. And we've negotiated special discounts for our members to receive health-related books and other medical publications.

Physician Referral Service

Good healthcare starts with a good physician. But where do patients find physicians? Often they will seek the advice of friends, look in the Yellow Pages or possibly use a hospitals physician referral service. While these methods are a good first step, we want to help patients find the physicians who specialize in treating the patient's specific ailment(s). To accomplish this, we created a physician listing which includes specific information on physicians. It is our hope that with more specific information, members will be able to find the best physician(s) for their needs.

Insurance Disputes Services

If you've ever been:

  • denied coverage or payment
  • had a low reimbursement (UCR - usual and customary rate)
  • had your policy rescinded
  • denied access to a specialist
  • been denied a medical procedure
  • COBRA issues

Our team of professionals will work on your behalf to help you get the care you require. And if you're covered by an HMO, PPO, traditional indemnity plan, Medicare or MediGap, we'll also be there for you to handle problems of non-payment, being dropped from your health plan, outstanding charges, bills that were incorrectly sent to you, and charges that should never have been made.

Medical Bill Auditing and Disputes Service
(paying properly)

Patients are often faced with high medical bills when uninsured or they go out-of-network. When faced with high medical bills, our services can help by auditing, disputing and re-pricing the medical bill to proper charges prior to, or after care has been rendered. Just like an accountant reviews a company's bills for proper charges, we'll review your medical bills for proper charges.
Original Amount Due Cost Reduced To Savings (fee not incl.)
$6,451 $0 $6,451
$12,000 $8,000 $4,000
$33,817 $2,800 $31,017
$200,000 $20,000 $180,000

Cost Navigator

Doctors may charge any fee they want for a service. Hospitals in Manhattan will charge more than hospitals outside Manhattan. The question is, how do you (the patient) find a quality doctor at an acceptable price?

Our Cost Navigator uses data analytics to identify high quality doctors and hospitals that perform services at acceptable prices. It is true, the cheapest isn't always the best. But data analytics do effectively identify high quality doctors that offer better prices

Example:

Provider Doctor Quality Cost (for same procedure)
Doctor #1 High $8,000
Doctor #2 High $12,000

Medical Research

When you or a loved one is diagnosed with a disease or illness, it seems you can't get enough information. We'll research the disease for you, investigate treatment options, provide lists of doctors and medical facilities who specialize in such treatment and identify support groups. We'll do as much research as you need so that you can make informed decisions about your next steps to recovery.

Prescription, Dental and Vision Plans

If you want to save money on prescriptions, dental or vision care, these plans are for you. A person's average savings is 10% to 30% off the price of prescription drugs; 35% off on dental costs; 20% to 60% off eye wear and 20% off on contact lenses. Most importantly, there are no forms. Simply show your card to the physician or pharmacy and they will automatically deduct your savings.

Health Counselor

As a member, you'll have access to advice through the Health Counselor. Your counselor can help you with everything from understanding how your insurance works, to choosing a doctor, to what to do if you have a problem. It can even answer questions like, what is a defined contribution plan? Your counselor can guide you through all parts of the healthcare system and point you in the right direction when you have questions.

Bills and Forms Consolidation Services

We'll sort through bills, figure out what's covered by insurance and return to you a simple, easy to understand statement that clearly tells you what you owe. Whether you are covered under an HMO, traditional indemnity plan, Medicare or MediGap, we have the expertise to completely understand your situation. And if during the review process they find money is owed to you, we'll even submit a claim on your behalf.

Elder Care Services

Our parents are aging causing new issues to face. These things include selecting an assisted living facility, transitioning from a rehabilitation setting to home, paying for nursing care, placement in a nursing home, protecting assets and much more. We help our members navigate these issues maximizing care and minimizing the out-of-pocket expenses.

Nursing Home, Assisted Living & Hospice Services

As our loved ones age we often find the need for a nursing home, assisted living facility or even hospice care. The questions are, which facilities are best? How can you pay for an assisted living facility? And what does Medicare cover? Let us help navigate this process

Health Plan Review & Assessment

Each year health plans change benefits and peoples' medical needs change. We can help review and assess your needs and your health plan to ensure proper coverage if anything was to happen to you or your loved ones

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