How Zelis helped a member save $51K on their health bill
Imagine receiving a bill for $51,000 when you were expecting to pay $2,800.
That’s exactly what happened to a member of a large third-party administrator’s health plan after routine surgery. Luckily, Heather Storms, a bill navigator on the Zelis Health Bill AssistSM team, was ready to help.
Zelis Health Bill AssistSM helps members deal with out-of-network medical bills that can be confusing, just like the one this member encountered. The service includes a navigation team that educates members about their out-of-network benefits and investigates bills. This potentially leads to processing or billing corrections and can even include negotiating hospital bills to help reduce costs. Heather and her coworkers prioritize making the entire experience less frustrating for members.
When Heather received a call from the member for help with a $51K health bill, she was quick to investigate. As it turned out, the hospital had accidentally made a huge miscalculation. This caused a significant discrepancy between the good faith estimate and final bill. To make matters worse, the member didn’t have the initial estimate in writing and wasn’t sure who provided the information.
Expert assistance on health bills when you need it most
Thankfully, the hospital’s notes confirmed the miscalculation, which was crucial for Heather’s case. The next step? Guiding the member through the hospital’s financial aid application required to proceed with a charity care review.
“I wasn’t letting it go. There wasn’t a moment where I fluctuated. I was more than motivated to help this member.” — Heather Storms, Zelis Bill Navigator
Medical bill negotiation support saves the day
Thanks to Heather’s persistence and expertise, the hospital recognized their error and, after reviewing the charity care application, significantly reduced the out-of-network medical bill. Heather’s efforts saved the member $51K out-of-pocket.
“When it’s your own personal experience, you don’t always have the emotional capacity to deal with it. It’s just too much. Our team offers a different mindset and knows how to speak to members to ask the right questions and present valid responses to providers. We know what conversation we need to have and how to best help the member.” – Heather Storms, Zelis Bill Navigator
Key takeaways to help members avoid unexpected health bills
Helping members navigate out-of-network medical bills
Working with bill navigators like Heather means having a trusted partner who understands the intricacies of medical billing and is dedicated to achieving the best possible outcomes for members. The personalized support and expertise provided by Zelis Health Bill AssistSM make a big difference in reducing financial stress and ensuring members receive the care they need without the burden of unexpected health bills.
Get started today
Learn more about how Zelis Health Bill AssistSM offers specialized support for out-of-network medical bills, reducing confusion and financial strain for members while improving satisfaction for employer groups.
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