Healthcare providers have a significant number of large dollar claims denied to patient responsibility for insured patients. These claims are often sent to collections or just written off. This costs your organization millions of dollars and creates a negative patient experience .
Instead of never collecting on these claims and angering your customer by sending them to collections. We offer another alternative. Athos Health will be your patients' advocate to help them overturn the denial. Instead of calls and letters from a collection agency, patients will have a partner to help them fight for insurance coverage.
Often, the first remediation step will be to file an appeal with insurance carrier on behalf of the patient. As part of this process, we will write an appeal letter in the member’s name that addresses the specific reasons why the denial should be overturned. We pair this with specific clinical, plan, and/or medical policy information to support our argument.
Most of us receive our insurance through an employer. We tap into this relationship if the appeals are unsuccessful. We provide tools and resources to help the patient approach their employer's HR team to ask the employer to intervene. Often self-insured employers will override the insurance's denial.
From our experience, we have found patients have a separate set of rights and opportunities to overturn these denials that are distinct from your organizations. Our approach taps into these rights by partnering with the patient to solve the problem. Not only does your patient have a positive experience, but your organization will increase its cashflow and reduce its bad debt. We are so confident in our results, our fees are 100% at risk.
Interested in learning more about our Patient Advocacy program and how we can assist your organization?