Healthcare Advocacy a Fixture at an Increasing Number of Companies

San Rafael, CA, February 5, 2001 — Helping employees resolve managed care health claim problems has become a bigger problem for employers, as complaints about slow payment, "lost" claims and improperly paid claims increase. The nationally broadcast PBS TV series That Money Show this week focused on one employer's solution to improve employee satisfaction and save time and money for Human Resources staff.

Tetra Pak, an international packaging company with its US headquarters in Vernon Hills, IL, is featured in the show's cover story. Tetra Pak has retained CareCounsel, one of the new breed of employer-sponsored healthcare advocacy programs to support its employees, as they navigate the complex managed care landscape.

Michael Tovar, Compensation and Benefits Manager at Tetra Pak, states, "It was almost a full time person to handle all the claims issues. And probably if you add in a compensation and benefits total package, we're spending a third of that for CareCounsel to do this through a 800 number and have everything be completely discrete."

The show spotlights Tetra Pak's VP and General Counsel, who was taken to collections after repeatedly trying on his own to resolve a health claim payment error that arose after he was hospitalized for cancer treatment. Despite being an intelligent health care consumer, the employee was unable to get his health plan to fix the problem and stop the hospital from taking him to collections. After he called CareCounsel, their "high-touch" employee benefits advocates effectively worked with the employer's health plan, with the hospital and with the collection agency to identify the error and correct it.

According to CareCounsel's CEO, Lawrence Gelb, "health plan claims problems are growing in frequency. In 1999 they made up 14% of our calls; in 2000 27% of the calls to CareCounsel were about claims."

Dr. Gelb predicts a growing use of employer-sponsored health benefits advocacy programs, as companies seek to outsource complicated, time-consuming health care assistance and troubleshooting functions to specialized firms like CareCounsel. "According to the Kaiser Family Foundation, 51% of consumers experienced at least one problem with their health plan in the last 12 months. Employers don't have the time, desire or expertise to respond to this regrettable reality."

CareCounsel helps employees choose from different health plan options during open enrollment, effectively use their managed care benefits, make informed decisions about choosing doctors and resolve issues with claims, provider network access, eligibility and quality of care.

This segment of That Money Show can be viewed online at:
http://www.pbs.org/wnet/moneyshow/cover/012601.html

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