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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

er 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
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SOURCE Patient Advocate Foundation
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