When it Pays to get a Second Opinion: Bill Reviews with HealthJoy

by | Apr 20, 2018 | Benefits

Medical billing errors are still vastly misunderstood, and reliable statistics on the issue don’t exactly agree: The American Medical Association estimated that 7.1 percent of paid claims in 2013 contained errors, a 2014 NerdWallet Study found mistakes in 49% of Medicare claims, and studies run by groups that address billing issues put the error rate closer to 75 or 80%, resulting in $68 billion in unnecessary healthcare spending in the United States If anything is certain, it’s this: it pays to get a second opinion before paying that medical bill.

Saving 7x at Alpine Painting

At HealthJoy, that’s just one way we save our members money. Here’s a taste of what our team worked on, just in the past month! 

An employee at Alpine Painting needed to locate a new provider and chatted with JOY and the HealthJoy concierge team to find a new doctor in his network. The HealthJoy concierge team took it from there, researching providers, comparing facilities, confirming an office could properly address his needs, and even scheduled an appointment for him.

The employee paid his copay at the doctor’s office and the appointment went off without a hitch, but he was surprised to receive a bill for $342 after the visit that should have been covered by his insurance.

He took a picture of his medical bill and submitted it to the HealthJoy concierge team for review via the HealthJoy mobile app. The team reviewed the bill, and reached out to his insurance carrier directly. They were able to identify that the doctor’s office had listed the wrong address to submit a claim to the member’s insurance carrier, and worked with the office and the carrier to resolve the issue on his behalf. The office updated their claims process, and he was able to disregard the bill, saving over 7X.

Spelling errors have steep consequences

An employee at Morgan Creek Capital had some routine lab work done as a part of his preventative care visit, all of which should have been covered by his insurance policy.

He was surprised to receive a bill from the lab, which wasn’t properly submitted. He took a picture of the medical bill in his HealthJoy app and the HealthJoy concierge team stepped in. They noticed a spelling error in his name and called the lab to correct his name and his insurance information, and helped the lab properly submit the claim to the third party administrator Morgan Creek works with. The concierge team confirmed that he wasn’t responsible for any of the charges, followed up with the member to disregard the bill, and ended up saving him $651.98.

Want to see how much HealthJoy can save your employees? Reach out for a demo.

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