Get a Superhero in Your Corner and Help Employees Navigate CO-19 Health Insurance Claims

By |2020-06-09T18:07:31+00:00June 8th, 2020|

As we all get back on our feet from Quarantine, the next wave of challenges we face will be medical bills and understanding health insurance costs related to COVID-19 (CO-19).

As a business leader, you want to get employees happily back to work and engaged in productive company goals. Nobody wants to get caught up in ongoing questions around health insurance benefits, especially for CO-19 care or testing. LA County offers ‘free testing,’ but what happens when an employee winds up with an unexpected bill from the testing facility, or any bill for medical care that they didn’t expect? Having employees saddled with such concerns compounds the worries they may have about returning to work.

We spoke with three industry experts to find out how you can support employees with health cost concerns at this time.

Sarah Prince, of United Agencies Insurance, who’s always watching out for risks their clients could face, has identified miscommunication about CO-19 testing charges. She told us to remind employees that ALL CO-19 testing is covered and that many telemedicine services are also currently available at no cost. She recommends clients share EAP (Employee Assistance Program) services that are available and, in many cases, have been expanded during this time.  EAP’s provide mental and financial health resources to employees and their eligible family members. If you furloughed  staff and are ready to bring them back, Sarah suggests talking to your insurance carrier as many are waiving new hire waiting periods for rehires to help everyone at once get back to work and to where they were pre-pandemic.

Danone Simpson, President and CEO of Montage Insurance suggests if employees are faced with a huge bill, whether CO-19 related or not, their first call should be to the insurance broker who knows the ropes and can (and should) help them navigate a map of what to pay and when to pay it. Simpson’s firm advocates that a broker should always offer their services on claims on a complimentary basis as “truly we are the face of all carriers service teams” says Danone Simpson. Montage in fact, employs a dedicated client and Insurance company liaison who spends her time handling client employees billing issues on the clients’ behalf. Peoplescape clients have experienced the knowledge firsthand and the value of having a helpful broker in their corner when they worked with Danone and her team at Montage.

Another creative way to help employees is with a medical billing advocacy service. Medical advocacy services provide employees a Superhero in their corner who verifies the accuracy of the insurance bills before the employee makes payment, and fights on the employee’s behalf in the event of an error.

The Alliance of Claims Assistance Professionals (ACAP)  is a nationally recognized association of independent Claims Assistance Professionals (CAP) who provide medical claims assistance and patient advocacy to individuals and businesses. Their fees can range from an hourly $50 to 25% of what was saved on the medical bill being reviewed.

One of the advocacy services about which Peoplescape has heard favorable reports is provided by CoPatient. Jennifer Burnham-Grubbs, CoPatient’s Co-Founder, explains the benefits of their service “80% of our clients are found to have errors in their medical bills and we have saved clients an average of $500 per bill through our service. It’s shocking but true that errors happen all the time, and most people don’t have the technical know-how or the time to fight the necessary battle for fair, accurate billing.”  Burnham-Grubbs  goes on to add something we too have learned recently while guiding our clients in their benefits choices, “The value of any employee benefits design can be improved by 20%, simply through the addition of a true deep-dive billing advocacy service that makes sure the insurance company pays out as it should”.

Clients have been so pleased with the service that we decided to hunt down Jennifer Burnham-Grubbs personally and ask her a few more questions.

Peoplescape: Jennifer, how involved does the employee have to be in using CoPatient to fight their bill and how much time can this take?

Jennifer Burnham-Grubbs: The beauty of CoPatient rests in its simplicity. One of their slogans is “because medical emergencies shouldn’t become financial ones.” When someone has a medical event, the last thing they need is extra stress, and the last thing they have time, patience, or money for is billing errors. So CoPatient simply asks users to login with their private account & upload copies of the bills with a brief description of the medical issue. From there, the advocates take over the workload and check back in as needed for added clarification. This completely removes the burden of double-checking bills before paying them – which can be hours and hours over the course of weeks, months or even years. For employers, it means better productivity and morale since fighting with billing departments can only be done during work hours. So, it creates a real win-win.

Peoplescape: This sounds great, how much does the CoPatient service cost?

Jennifer Burnham-Grubbs: “We recognize the financial uncertainties everyone is facing right now and are currently offering CoPatient services for FREE through September 2020. This covers claims retro-active to March 1, 2020, when CO-19 first started having an impact. Regularly, CoPatient is available to companies with 10+ employees for $3/month/family on an employer-sponsored basis, or $6/month/family on a voluntary basis”

Peoplescape: Do you have any tips for small business on their renewal strategies for keeping costs down while still protecting employees fully, especially as they return to work post-quarantine?

Jennifer Burnham-Grubbs: Absolutely. In fact, I’ll be presenting on this exact topic at the E1C20 Virtual Conference by Ease (one of the premier Ben-Admin portals on the West Coast) June 8th and 9th since it’s a subject on everyone’s mind. The #1 priority is real value. What delivers ROI and what doesn’t? What do employees really use/want, and what is wasted? For example, HSA high-deductible plans are still not widely adopted but they should be – especially if combined with value-rich ancillary boosts like Healthiest You (free, unlimited 24/7 Teledoc that includes mental health), CoPatient, and Dental benefits.

One thing business owners may not realize is that 70% of all ER visits can be avoided with telemedicine. By supplying good telemedicine benefits (at a fractional cost), employers can implement less expensive major medical plans and create a net saving that keeps employees happy. Similarly, when employees learn how to use HSA plans the right way – especially if they have billing advocacy and review to help defray deductible costs – they get coverage at a lower price that still meets their needs. Dental is something which also shouldn’t cost an arm and a leg, but which employees do really appreciate. So, it’s about figuring out where to invest in benefits, so each dollar spent works smarter. When employees see their employer has made real effort in this regard, they can accept traditional ‘downgrades’ because they understand the big picture. There is a delicate balance with downgrades – slash and burn never goes well. It requires sensitivity, expertise, and innovation on the broker’s part, as well as willingness to educate.

Peoplescape: There’s a growing wave of digital health apps that use smartphone features to collect diagnostic data. What do you see as the ‘next’ thing in healthcare that small business owners could take advantage of?

Jennifer Burnham-Grubbs: I love this question because it speaks to the “X” factor in building healthy company culture on all levels – personal, professional, and physical – as well as the need to keep one’s finger on the pulse of changing trends. My answer to this question may surprise you. I think that – especially with quarantine – our appetite for the digital has somewhat diminished. We’re plugged in more than ever and smartphone features have proliferated wildly. What’s most special now is structured ‘unplugging’. For example, I know an HR professional who organized lunchtime walks with (voluntary) ‘teams’ within her company and friendly competition to see who kept up the habit most regularly. The response, she said, blew her away because it became such a positive activity within their culture on all levels. Even working remotely, it’s possible to organize meaningful team ‘fitness challenges’ and build cohesiveness at minimal expense. Also, mindfulness apps seem to have gained interest. Companies can sponsor a platform such as InsightTimer or Headspace and help move the needle on overall wellness. This isn’t to say traditional smartphone perks have gone the way of the dodo; it’s just a reminder of how much is readily available today without extra gimmicks. I like to focus on solutions that give back much more than they cost overall.

At Peoplescape we are always looking for new tools for clients to enhance their employee wellness. If you are interested in learning more about healthcare apps, here are just a couple we found:

The Australian company ResApp Health makes apps that use a smartphone to record and transmit the recording of a cough. Tel Aviv-based Healthy.io makes an app that uses the smartphone’s camera to measure aspects of a patient’s urine. Researchers at the Centre for Eye Research Australia (CERA) developed a tablet app that uses computer vision to recognize early signs of Alzheimer’s in the eye of the user

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