Benefit Advocates for HR Professionals

Supporting the Health of Your Employees and Your Business

In today’s complex and competitive healthcare market, you need a strategic business partner who understands your challenges and delivers competitively priced benefit solutions that can directly affect the bottom line.

Time is Money – Every hour you spend managing complex healthcare benefits issues is time lost to core business activities. Likewise, time lost for employees spending hours trying to make the best use of their plans or resolving benefits issues is time lost to revenue generating business lines and productivity levels.

We are a seamless extension of your benefits team, an industry leader you can rely on to free up internal resources. Rates are customized for each client. Our most popular rate option is a monthly/per-employee fee providing access to the full range of our services.


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On-going Analysis

benefit-advocates-hr-professionals-3Throughout the year, Benefit Advocates can analyze an employee’s coverage before expensive medical procedures are sought to determine the highest quality provider at the best price. We will customize our support for your individual employees, providing cost estimates, so employees can make appropriate decisions (saving dollars for you and them). We can also intervene on behalf of your employees where providers have billed or coded items incorrectly.

The Medicare Maze

benefit-advocates-hr-professionals-4More and more employees are continuing to work beyond age 65, resulting in increasing disputes over primary and secondary claims coverage. Last year alone, our team of benefits experts saved our clients hundreds of thousands of dollars in Medicare related claims.

Outpatient Diagnostics Cost Management – Outpatient diagnostics are the fastest growing medical expense for plan sponsors. We gather cost estimates to ensure employees receive the best care at the best price and contain costs.

Claims Resolution – Billing errors by hospitals, labs or doctors or overcharges above plan guidelines can easily add up and affect plan pricing at renewal. We help avoid these extra costs by diligently checking disputed claims so plans and employees pay the right amount for services rendered.

Customized Reporting and Analysis – One size does not fit all. We’ll provide the metrics and reports you need to meet your unique goals and objectives.

Real People, Real Answers

How many times a day are you interrupted with health plan questions from employees? They want confidential, compassionate guidance and support. We can create a customized call center for your employees with the service they need. Our confidential services are HIPAA compliant and provide:

  • Confidential counsel to resolve sensitive medical, pharmacy, mental health and other issues
  • Mediation between employees, health plans and providers
  • Full-service support of your annual enrollment processes with in-person, online and telephonic enrollment options
  • Employee guidance in choosing plans during annual enrollment and a customized, co-branded health newsletter for support throughout the year
  • Expertise in resolving denied claims and billing errors for health, dental and vision plans
  • Advocacy and education in effective use of wellness/work-life and employee assistance programs, nurse hotlines and other health and disease management programs
  • Education about cost-savings opportunities through increased use of generic drugs, mail-order pharmacy services and network providers
  • Research to select the best doctors, hospitals or treatment plans; ensures best pricing for outpatient diagnostics and other services; confidential second opinions and more
  • Negotiation with providers for out-of-network or out-of-pocket expenses
  • Simple, straightforward information about Medicare for retirees, employees and spouses who are disabled or over 65

Medicare Advisory Services

Benefit Advocates offers comprehensive Medicare Enrollment consultation and training for your HR/benefits team. We can work with individuals and groups, and we offer on-site presentations and webinars to help older workers understand Medicare and how it relates to them. Call us to discuss this important topic further. Our Medicare services also include:

  • Helping retirees transition from active to retiree health plans and helping them understand when to apply for Medicare and selecting a plan
  • Resolving health, dental and drug claims, or denials of coverage
  • Consulting to help retirees understand health plan provisions and to evaluate the best options at retirement
  • Locating the best doctors, hospitals and second opinions
  • Annual enrollment support & training

We have a guidelines booklet available that has great information for employees who plan on continuing to work after they turn 65. Click here to order a copy, or contact us if you want a multiple copy discount.

Annual Healthcare Insurance Enrollment

When was the last time you said your annual enrollment was a breeze? Let Benefit Advocates provide you with turn-key solutions to make the yearly transition an opportunity to educate and coach your employees, so they understand and appreciate their health benefits. We offer:

  • Strategic benefits communications plan development
  • Comprehensive editorial and design services
  • Presentation development
  • Scheduling coordination and execution
  • Training sessions

As more benefit packages move to Health Savings Accounts (HSA), and/or High Deductible Health Plans (HDHP), look to Benefit Advocates to help you maximize every dollar spent on care, procedures and prescriptions.

We have a number of tools available to help you find the best price with quality providers that fit with your healthcare needs, so you can get the best care and value for your money.

  • Prescription drug prices vary widely, and we are qualified to review prescriptions to determine the most cost-effective outlet to purchase them.
  • From MRIs and colonoscopies to mammograms and x-rays, Diagnostic Radiology is the fastest growing area in the health care. With our extensive knowledge of care providers, we can find the best quality, most affordable providers in your network.
  • Surgery is never something that should be taken lightly. It can also be very stressful for the patient, and for family members. When you have questions, we have answers. We can help find the best quality and best price for both hospitals and surgeons. For HSA/HDHP policy holders, this “second opinion” can lead to exceptional care for less.

Our Quality Assurance Guarantee

Employers receive performance guarantees. We provide a new client implementation scorecard and a participant survey of all callers following the first six months of your program, and regularly thereafter. If we do not score 85% of satisfied or very satisfied with our service, we will refund you 25% of the quarterly fees. We’ve never paid out a penny, but it is proof that you can choose Benefit Advocates with confidence. We also carry errors and omissions insurance; we document every call and record all incoming and outgoing calls – just in case.