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Leading National Patient Advocacy Group Delivers Warning to U.S. Patients: Having Health Insurance Does NOT Mean Your Medical Needs Will Be Covered
Date:2/14/2008

Non-Profit Foundation Has Assisted Over 6 Million Americans Since Its Inception in 1996 With Rejected Insurance Claims and Coverage Denials

NEWPORT NEWS, Va., Feb. 14 /PRNewswire-USNewswire/ -- The Patient Advocate Foundation (PAF) - a national non-profit organization providing information and services to millions of patients with life-threatening, debilitating and chronic diseases each year who are unable to obtain access to healthcare because of financial issues or insurance denials - warned Americans today that having private or public health insurance does not ensure that their medical needs will be covered.

Over the past 12 years, PAF's expert case managers and medical professionals have helped nearly 20 million patients gain access to healthcare when denied coverage by their insurance provider. In 2007, more than 6.8 million people from all 50 states contacted PAF for information - approximately 44,000 of those requests requiring direct, sustained mediation from PAF. Of those 44,000 cases, 76 percent of the patients had some form of insurance, whether it was private healthcare, Medicare or Medicaid.

"Unfortunately, it is a common misconception in America that just because you have health insurance, you will get the medications and medical care that you need - particularly when faced with a life-threatening, debilitating or catastrophic health crisis," said Nancy Davenport-Ennis, founder, president and CEO of PAF. "We have seen entirely too many patients and family members struggle with rejected claims, denials based on pre-existing conditions and additional insurance coverage challenges that can lead to life-or-death delays in treatment."

Recently featured on CNN for its expertise in helping uninsured and insured patients access healthcare, PAF offers free assistance to hundreds of patients from across the United States each day - including those living with cancer, heart disease, HIV, kidney disease, diabetes and other serious conditions - to access their prescribed medications and services, obtain relief from medical debt crisis and maintain their jobs during a health crisis. In addition to offering one-on-one guidance to patients as they try to navigate their maze of insurance coverage information and the appeals process, the Foundation provides Web-based patient services; live patient chats; PAF-authored publications; state, local and national outreach; and projects targeting specific patient populations.

PAF helped Westlake Village, Calif., patient Melvin Kane, who suffers from a degenerative joint disorder, get his medical bills paid after many frustrating months of battling with his insurance provider. "We had run into a brick wall with our insurance company, as well as with the medical provider," said Melvin's wife, Suzanne. "We had begun to feel like we'd sunk under a mountain of debt." As a result of PAF's intervention, Melvin and his family have now received write-offs for his medical facility and his provider bills.

PAF suggests four general steps for battling insurance issues, further explained by its expert case managers and on its website, http://www.patientadvocate.org:

1. Gather information: Organize paperwork into one place so that you can easily access key documents.

2. Educate yourself: Learn about your illness and understand your insurance policy.

3. Write appeal letters: There are two types of appeals, a doctor's office appeal and a direct appeal.

4. Evaluate the results: Ask for your insurer's appeal decision in writing; if you are denied, find out if your state has an external review board for you to contact.

"Disease can happen to anyone, and it can have an earth-shattering effect on a person's physical well-being and family - especially when medical needs are not being met due to payment issues," said Davenport-Ennis. "We at PAF are committed to working tirelessly on behalf of all patients - insured and uninsured - who need assistance getting their pressing medical services covered, and we encourage anyone with such a need to call on us for help."

For more information about PAF and its services, contact 1-800-532-5274.


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SOURCE Patient Advocate Foundation
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