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2.10.2010

Discover Health Advocacy: Unreasonable balance for a surgery bill

We built our company, Health Advocate, Inc., to help people navigate the complex healthcare system and to provide them answers when they need them the most. Here is an example of how we have helped a member with a healthcare solution.

Problem: Unreasonable balance for a surgery bill

Sharon had emergency surgery at an in-network facility, but received a large out-of-network balance bill because the on-call surgeon who performed the procedure was not in her plan’s network. Although Sharon’s insurance company paid the claim at the highest plan benefit level (90 percent of allowable), Sharon was still left with a $4,230 balance.

Solution: Health Advocate negotiated with Sharon’s surgeon to lower her payment to $2,000, saving Sharon $2,230.