Services: Patient Advocacy

According to a recent study, more than 50 percent of all Americans experienced a problem with their health insurance over a year's time. Health care can be a complex, confusing and sometimes frustrating process. That's why The Benefit Advocates was formed: to act as a guide and advocate for employees through the maze of managed health care.

We  provide health insurance and benefits advocacy and assistance to employees, retirees and their families. Our telephone advocates are available Monday through Friday from 8:30 a.m. to 5 p.m. Eastern Time to help resolve issues that would otherwise waste countless hours of productivity — calls by employees to insurance providers, doctors and human resources staff. Instead of a resolution, the result often is an exasperated employee and a lost workday.

The Benefit Advocates can ease these headaches by providing confidential advocacy assistance, education and coaching for employees. Advocates can explain or resolve disputed medical claims or denials of coverage and help employees understand policies on experimental treatment, reasonable and customary care limitations and out-of-network care.

Remember, advocates are available in the Call Center from 8:30 a.m. to 5 p.m. ET Monday through Friday. Call 336-721-2029 or 1-800-344-5677 or e-mail us at info@benefitadvocates.net. Employees can also get general medical and benefits information at any time through this Web site.

Employer Benefits of Patient Advocacy

• Increased employee awareness and appreciation of benefits
• Increased productivity as employees spend less time resolving benefit issues
• Increased employee satisfaction with their benefit plan
• Supports your commitment to offer high-quality, cost-effective and user-friendly benefits to employees
• Supports HIPAA compliance by maintaining confidentiality of employees' medical information
• Can Encourage Employee Enrollment in Managed Care Options Because of Availability of Support
• Frees HR/Benefits staff to focus on strategic functions and improves efficiency
• Provides employers with better data through reporting of calls by issue type, employee status, geographical location and intervention.

Employee Benefits 

• Faster and more effective resolution of issues by skilled and experienced advocates.
• A knowledgeable source to call for general health care information and details on specific plans and programs offered by employers.
• Better time management as more work hours are spent on core business activities instead of resolving health insurance questions.
• Resolution of sensitive and difficult medical issues by an independent third party maintains confidentiality and privacy without the need to inform or involve employers.
• Expert guidance for appealing insurance plan decisions.

The Benefit Advocates can help answer these and other questions:

"I have a medical claim that is past due. My health plan just can’t seem to get it paid. How can I make sure the bill gets paid?"

"My sister was just diagnosed with multiple sclerosis. Where can I learn about the disease?"

"I’m so confused about all of the insurance choices. How do I decide which plans are best for my family?"

"My claim was denied because the health plan said it was not medically necessary. My doctor disagrees and said the treatment was necessary — what can I do?"

"I took my husband to the emergency room on the weekend. Now my health plan refuses to pay because it did not consider the situation a true emergency. What can I do?"

"Are generic drugs as effective as name-brand drugs and how do you know if a generic equivalent exists?"

"My doctor dropped out of my health plan’s network. How do I choose a new primary care physician?"