Problem
An employee recovering from ankle surgery reached out to Emry, concerned after receiving a statement of benefits (EOB) and a subsequent hospital bill for $88,000. This unexpected financial obligation had left the patient facing substantial medical debt.
Solution
After confirming with the patient that the injury was personal and not work-related (thus eliminating the possibility of a workers’ compensation claim), Emry investigated, tracing the billing discrepancy back to a missing Accident Claim form, which was not provided to the patient during their hospital stay. Through persistent, thorough communication with both the hospital and the insurance company, Emry ensured the patient’s bill was accurate and appropriate.
Results
Emry’s proactive intervention and identification of a procedural oversight, resulted in a major alleviation of financial burden for the member. Through meticulous examination and negotiation, Emry managed to reduce the initial $88,000 out-of-pocket expense to $794.
