Medicare/Medicaid-Benefits and Applications
Understanding what Medicare/Medicaid covers and doesn’t cover seems to get more confusing every day! Let PAFY take the confusion out of it. We can provide Information on what is covered by Medicare along with the options available. We can also assist with the confusing Medicaid application process and bring in skilled, affiliated resources (i.e. attorneys), if needed.
Explanation of Insurance Plan Benefits
All insurance plans are different – and constantly changing, so it seems! PAFY will assess your specific benefit package and explain any qualifiers for the benefit to apply. When appropriate, PAFY may be able to identify opportunities to challenge the category of benefit the insurer applied to secure more favorable coverage (see Appealing Coverage Decisions).
Appealing Coverage Decisions
Many people do not realize that an Insurer’s initial decision is not necessarily the final word. PAFY is willing to go to battle for its clients and appeal decisions we believe were made improperly. We will manage the appeal process, provide written documentation and, if necessary, make personal appearances at hearings to clarify the needs of the client while matching the policy coverage decisions. This is another way PAFY Makes Healthcare Work For YOU!
Review Billing and Deductibles
It is not unusual for Insurance companies to make billing errors. PAFY is prepared to review billing from various sources related to provider visits, treatments or medications ordered. We make sure charges are allocated to the appropriate policy deductibles to ensure clients get the maximum benefit from their health insurance.
Long Term Care Insurance Support
PAFY is a strong proponent of securing Long Term Care Insurance for clients while they are young enough to have reasonable premiums. PAFY personnel can assist with finding insurance agents to identify coverage options. For clients with Long Term Care Insurance, we can assist in accessing the long term care benefits by reviewing the policy coverage and providing the necessary information for the insurance company to initiate payment.