Can we just admit it? Healthcare and insurance are confusing! I was a broker for over three years, and I still couldn’t parse a medical bill to save my life. As an Employee Benefits Consultant, no one knows your groups better than you. But, if an advocacy program can help take some of the load off your desk by answering many of those employee questions during fourth quarter, wouldn’t that be nice for your groups' HR teams, employees AND you?

5 ways installing a quality advocacy program will help you and your groups...

1. They answer questions 

Every group continues to face plan changes year after year, all striving to keep costs contained. Deductibles, networks, Rx tiers, and copay amounts are in constant flux. Maybe you even changed carriers just to avoid as much of an increase as possible. With all these changes piled on year after year, it’s likely your groups have a LOT of questions. Just because you provided a "Summary of Benefits” doesn’t mean the layman individual understands the ins-and-outs of their plan. Advocacy services provide a health advocate who will assist employees in understanding the breadth of their plan, how to best maximize their dollars, and be there for the employee who needs additional help. 

2. They find the right providers 

Speaking of changes, it’s no secret that today’s health plans include much smaller networks and employees are having a harder time finding providers. This is where advocacy services can step in and work one-on-one with the individual to find local, high-quality doctors, hospitals, dentists and other healthcare providers in the plan’s network. 


 

3. They get cost estimates  

Once the employee has grasped the intricacies of their insurance plans, the healthcare advocate is able to take it one step further by getting cost estimates for various procedures. Many people don’t realize how much costs can fluctuate for the same procedures, even in close proximity. With an advocate’s guidance and expertise, employees will be equipped with the tools and foresight to get the best deal from the start. When this happens, employees can feel good about their choice, and they aren’t surprised when the bill shows up in their mailbox. Click here to read a real-life story of how advocacy services work.  

4. They book appointments and procedures 

What good is all this knowledge if employees run into issues when they actually use the plan? Once again, an advocate helps ease the burden by assisting the employee in booking appointments and procedures. Let the advocate call the office, freeing up that employee’s time to continue working and avoid the headache of scheduling appointments. This is especially helpful with providers who are popular and hard to book because advocates know how to get those appointments.

5. They help with medical bills 

Ugh, I don’t know if you’ve personally dealt with or had someone you know deal with a huge medical issue, but it’s not pretty. It’s been estimated that over 40% of medical bills contain errors. In 2010, Kaiser Health News estimated that nearly $68 billion is being lost to fraud and billing mistakes each year. Providing your groups with a medical billing expert advocate can guard them from paying erroneous bills. They can review for accuracy, organize and negotiate on an employee’s behalf many medical or dental bills. Here’s one of the best stories I’ve heard: “I received a $1,500 bill 11 months after my service! I called my advocate. They did all the work… to let me know I didn’t owe anything.” This saved time and money - every employee would call advocacy service a benefit! 

Health Insurance is one of the few investments that you routinely do NOT want to see utilized. As individuals are asked to take on more up-front costs, it’s even more important to equip them with the knowledge to efficiently use their benefits. Don’t just sell your groups a medical plan. Provide them with the tools they need to get the most value out of their dollars spent. 

Now it’s your turn! Have you included advocacy in your mix of benefit offerings? Are you thinking about adding this service? Comment below or email brokers@freshbenies.com.