Claims Advocacy

The simple power of a human being answering a phone call has become a rare luxury. When that human being can also serve as an advocate on behalf of employees and their dependents, that service becomes invaluable. At Benefits 7, our experienced, full-time claims advocate answers questions and makes the convoluted language of insurance claims easier to understand. When employees or their dependents need help with coverage issues, claims processing or appeals, our claims advocate goes to work to ensure as smooth a process as possible, determining in-network vs. out-of-network provider options, refunds due, and if payments have posted. The result? Happy employees, reduced costs, fewer delays, and peace of mind.  

Claims Advocacy Success Stories

• By acting on behalf of a client who mistakenly paid $1,500 that he thought applied to a deductible, our claims advocate worked with the physician and carrier, and the client ultimately received a refund of $1,100.
• A client had $26,000 in unpaid claims. Repeated appeals were denied by the insurer, but our claims advocate worked with the providers to help reduce the client’s out-of-pocket costs by $21,824