Medical Advocacy as a Value-Add

Taking Healthcare Benefits to the Next Level

Add a white branded supplement to your existing services that provides email, phone or video chat access to highly trained, experienced medical advocates who, through a 3-Tier system, can field questions, recognize problems and identify solutions ranging from benefit plan questions through highly complex, challenging medical questions.

Tier 1: Insurance/Benefits Explanation

  • Explanation of SOB
  • Co-pays
  • Deductibles
  • In-network and out-of-network costs
  • Drug coverage

Tier 2: Billing/Coding and Insurance

  • Comprehensive bill organization
  • Line item review of each bill for errors and omissions
  • Claims review and EOB
  • Negotiation with collection agencies for a reasonable payment plan
  • Bill negotiation

Tier 3: Comprehensive Healthcare Advocacy and Navigation

  • Real time answers to complex medical issues
  • Education for best utilization of healthcare system
  • Experienced, expedited access to best care
  • Identification of best in-network providers and facilities
  • Cost comparison for tests and procedures
  • Early detection, prevention and wellness through education, monthly newsletter and most up-to-date material, followed by ongoing guidance and support towards a healthier
  • lifestyle to encourage health and resilience
  • Confidential support and education for mental health and addiction
  • Wrap around care management of chronic diseases: diabetes, asthma, depression, etc.
  • Education on appropriate use of an emergency room with identification of appropriate alternatives

Financial Terms

  • A cost/employee/month (that pricing has a range depending on the number of people: the cost goes down with more employees)
  • A cost/hour that is a $100/hour effective

Our billing is line itemized, completely transparent, and we bill to the minute, with no rounding up.

Every contract starts with a three-month trial: This enables us to work closely with you to ensure absolute cohesiveness between companies and excellent customer service in meeting the needs of all employees. We are flexible and can change easily to needs not anticipated, whether staffing, pricing or services rendered.  We stay engaged to ensure quality care.

Prism looks forward to providing a comprehensive service that guarantees your ability to expand and differentiate your client support.  Additionally, our medical advocacy provides personal, experienced healthcare guidance at a time most needed for all your employees.

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