BRONZE PLAN – for healthcare claims, including Medicare, and therapeutic services
- Organize medical bills, with EOBs
- Audit bills for the correct procedure code for the service rendered
- Determine what was paid to your provider and applied to your deductible
- Determine how much is owed and to whom
- Review bills according to your plan’s provisions including hospital bills
- File an appeal for denied services in insurance accepted language
- Recover overpayment for you
- Negotiate payment terms as may be needed with providers on your behalf
- Provide quarterly summaries of all your claim activity
- Provide end of year totals for use on income tax filing
- List of standard questions you should ask your physician
Annual Pricing: Individual $275; Individual + one dependent $450; additional dependents $100
SILVER PLAN – includes Bronze Plan Services for healthcare claims, including Medicare plus
- Review of pharmacy claims
- Medication review for similar type and purpose prescribed by different providers
- Review medications for conflicting actions that may affect effectiveness
- Immediate notification of medication conflict or incompatibility to all providers
- Over-the-counter and supplement analysis for any conflict with prescribed medication
- Medication education guide for each medication, including side effects and food incompatibility
- Notification to all providers of all medications prescribed keeping all physicians up to date
Annual Pricing: Individual $350; Individual + one dependent $550; additional dependents $100
GOLD PLAN – includes Bronze and Silver Plan Services for Healthcare claims, including Medicare plus
- Review of Dental and Vision claims
- Long term Care review
- Obtaining letters of Medical Necessity as needed for healthcare, Medicare, Dental, Vision and Long term care
- Appeal of Dental, Vision, and Long term Care denial
- Negotiation of Dental, Vision, and Long term Care fees
- Nurse Sandi phone consultation up to 15 minutes to assist in determining appropriate specialist need
- Specialist locater within your plan
- 2nd opinion physician referral
- 10% discount on Lifetime Medical Cost Projection
Annual Pricing: Individual $389; Individual + one dependent $589; additional dependents $100
DIAMOND PLAN – includes Bronze and Silver and Gold Plan Services for Healthcare claims, including Medicare, Dental, Vision, Long term Care plus
- Provide analysis and assistance in choosing appropriate medical plans during open enrollment periods
- Assistance in determining your HSA or FSA yearly contribution to meet medical needs
- Assistance in determining the best Medicare and supplemental plan in your area
- Provide end of year totals for use on income tax filing
- Disease education guide for each of your medical conditions
- Initial phone consultation with Nurse Sandi
- Change in condition phone consultation with Nurse Sandi
- Customized questions YOU need to ask your healthcare provider
- Individualized Medical Care Plan for you and your Caregiver
- 20% discount on Lifetime Medical Cost Projection
Annual Pricing: Individual $425; Individual + one dependent $625; additional dependents $100
A La Carte services (if not part of your plan, or non-plan participant)
- Letter of Medical Necessity $35 plan member $75 non-plan member
- Medical Provider Bill Review per 30 day date range $150 non-plan member only
- Hospital Bill Review per admission 1% of total hospital charges up to $125,000; 0.5% over $125,000
- Medication, Over-the-counter, and supplement compatibility review and assessment $75 plan member $150 non-plan member
- Appeal of Insurance denial per denial $75 non-plan member only
- Nurse Sandi phone consultation up to 30 min $50 plan member $75 non-plan member