If you or your employee came down with a complex medical problem wouldnt it be great to have help dealing with the paperwork or correcting billing problems? And wouldnt it provide peace-of-mind to have an advocate who would coordinate multiple diagnostic tests and facilitate the transfer of medical records?
You can have that sort of help and more from a Personal Health Advocate a new feature available through the AGC Health Plan.
The Personal Health Advocate is a trained professional typically a Registered Nurse who understands the intricacies of the healthcare system and how to navigate through it. Personal Health Advocates demonstrate a commitment to service excellence have strong problem-solving skills and support members as they seek healthcare services and interact with providers and insurers. Personal Health Advocates work in tandem with Medical Directors and a team of administrative experts who handle claims benefits grievances and paperwork issues.
The Personal Health Advocate helps members coordinate care among physicians and medical institutions in various ways. Just a few examples are:
• Helping members understand tests treatments and medications recommended or prescribed by their physician.
• Assisting members through a complex medical condition.
• Arranging for home-care equipment following discharge from the hospital.
• Facilitating a review of test results with another physician for confirmation of a diagnosis.
In addition Personal Health Advocates help sort out and solve claims and related paperwork problems. We work on coverage issues and help members understand the coding and payment rules that apply to their circumstances. Some examples:
• Researching a members outstanding out-of-pocket responsibilities and resolving errors with providers and/or members health plan.
• Correcting balance-billing problems.
• Resolving eligibility problems and benefit and claim denials.
• Correcting charges incorrectly applied to the members deductible.
• Resolving questions about whether services are condition-specific or related to preventive care.
Personal Health Advocates enhance your total health care experience by proactively serving as your personal guide through the health care system – They know where to go and the questions to ask. They save you time and money by eliminating the hassle of never-ending phone calls and information searches – They do it for you.
The advocates are provided by Health Advocates an independent company that contracts with the AGC Health Plan.
The AGC Health Plan for Washington State offers a unique selection of plan and coverage choices at competitive prices to meet the varying needs of AGC members. For more information about the Personal Health Advocate feature or about the AGC Health Plan in general contact Margaret Huling one of the exclusive agents for the AGC Health Plan via email at firstname.lastname@example.org or by phone at 888.374.6224.