AdvocateATX Patient Advocates

One of the many things we do at AdvocateATX is deal with health insurance denials. Health insurance denials are tricky business. Board Certified Patient Advocates are highly skilled individuals that have the insight and knowledge to navigate these. Trying to navigate an insurance denial alone can be a disaster. Having an advocate can provide peace-of-mind, knowing that your denial will likely be overturned*. Insurance companies make denials and appeals difficult to read and understand, but patient advocates at AdvocateATX know how to deal with these documents. Allowing an advocate to take over and create a successful appeal can benefit you tremendously. Advocates can save you time and money by forcing insurance to pay when they would rather not. In fact, most initial denials are likely just needing some additional explanation. Advocates at AdvocateATX know how to create appeals that are successful. Don't deal with an insurance denial alone, when you can have a patient advocate help you. One insurance denial can literally ruin your life, but patient advocates at AdvocateATX can get your life back by creating an effective appeal that will get your denail overturned quickly and smoothly.

• Identify where it tells you "How to Appeal" in the literature they send you with your denial.
• Find out how long you have to appeal (could be 30, 60 or 90 days up to 6 months).
• Follow the instructions on the "How to Appeal" instructions.
• Make sure to include all pertinent information like what the case number is, your name, member id, etc.
• Get a letter from the physician that helped you, stating the treatments you received were medically necessary.

Write a persuasive document detailing why the treatments you received were medically necessary, include any important documentation like progress notes, clinical documentation, etc. that you can get from your doctor. Keep it professional and direct, and be sure to say what COULD happen if those services were not (or are not) received.

At AdvocateATX, Board Certified Patient Advocates can help guide you through a private insurance appeal. We can help with health insurance denials, utilizing our expertise in insurance jargon and knowledge of healthcare. We can make sure that your insurance denial gets approved by private health insurance, Medicaid or even Medicare and Medicare Advantage Plans. We have the background and knowledge needed to create a successful insurance appeal and get you the care (or money) that you deserve.

Appealing a Denial for:

-medication

-out-of-network

-payment for hospital stay

-continuation of care

-exception to policy

We can do it all here at AdvocateATX. Board Certified Patient Advocates learn over hard work and time, the complexities of the insurance world and know how to deal with them effectively. Let the patient advocates at AdvocateATX work for you to get insurance to do what they should.

What is the code of conduct?

• Ethical standards for Patient Advocates
• Moral obligations
• HIPAA regulations 
• Continuous learning 
• Informed Decision Making
• Nonbias 
• Nondiscrimatory
• Legal matters for health advocates

We are professionals with high standards to bring you the quality care you deserve.