Personal Service

Advocacy that Makes a Difference

A case study of an employee who needed an advocate while dealing with medical bills resulting from the employees child’s emergency treatment. The child of a client’s employee suffered a fall and broke five teeth while away at college. The student needed two root canals, an ambulance ride to the hospital, an emergency room visit, a CT scan, and restorative dental work. After multiple bills from different medical and dental providers began to accumulate, the employee contacted the insurance companies to find out which services were covered but got inaccurate information. The Paradigm Group claims advocacy team worked directly with the employee to explain the various bills and ensure that claim were filed correctly. In addition, the team convinced the student’s out-of-network dentist to accept the insurance company’s in-network fees as payment in full and to file claims with the medical plan rather than with the dental plan.