Advocating for Our Members
Once the initial shock wears off, the challenges of a being diagnosed with a critical medical condition can be overwhelming. What are your choices? What's covered? What's next?
Through the Member Advocacy Program, a personal advocate can help walk you through this difficult time with help in:
- Obtaining pre-authorizations and prior approvals
- Understanding medical jargon
- Navigating health care networks and managing physician referrals
- Walking through medical bills and Explanations of Benefits (EOBs)
- Speaking to medical staff with you, or on your behalf
- Suggest community resources for services not covered by insurance
- And more
If all that seems beyond the scope of services you would normally expect from an insurance company, that's because it is. We're here to remove barriers to health care and vow to be creative and caring in doing so.
The Member Advocacy Program is available at no extra cost to BCBSND members who qualify.
Who Can Participate?
Currently, candidates for the Member Advocacy Program are determined on a case-by-case basis, and include those who:
- Are born severely premature
- Have congenital defects
- Have pediatric cancer
- Experience a traumatic injury
- Undergo a transplant
Know Someone Who Would Benefit From This Program?
If you, or someone you know, may be a candidate for the Member Advocacy Program, please contact an advocate at 877-528-5140 or email@example.com. There's no need to include personal health information in your email message, we'll contact you for that information.
Meet the Thompsons from Minot:
Even before he was born, little Palmer Thompson was diagnosed with spina bifida. It was just the beginning of a flood of medical bills and insurance statements for out-of-state specialists, surgeries and hospital stays. The Thompsons were overwhelmed.
Then they received a call from a BCBSND member advocate. "It was music to my ears," says mom, Angie. Among other things, the advocate took the time to handle the legwork and monitor claims so they were paid at the best possible level. "It's wonderful to know they're watching over us, and I can always call someone who is familiar with our family," Angie says. "I'm able to focus more on our two beautiful sons instead of worrying."
Corey Pavelko and Case Management Coordinator Wendy Barta of BCBSND have forged a remarkable bond as Corey has battled life-threatening conditions more than once.