Frequently Asked Questions

How long has CareCounsel been in business?

CareCounsel was incorporated in December 1996. We launched our first employer-sponsored health advocacy program with Target Specialty Products in February 1998 (Target remains a client to this day).

Where is CareCounsel located?

CareCounsel is based in San Rafael, California, just north of San Francisco’s Golden Gate Bridge.

What are the advantages of CareCounsel?

CareCounsel‘s healthcare advocacy service helps employees, retirees and their families more effectively address healthcare and insurance-related issues. Our advocacy service is welcoming and user-friendly, resulting in a program utilization rate that leads the advocacy sector. Plus our focus on measuring employee satisfaction through comprehensive surveys allows us to continuously improve our level of customer service.

What are the benefits of CareCounsel for Employers and Plan Sponsors?

  • Saves time and money for your organization and employees
  • Supports your Human Resources staff
  • Increases employee satisfaction with their benefits
  • Demonstrates a commitment to employees and their families, as healthcare grows more complex and costly
  • Improves employee satisfaction and morale
  • Increases productivity
  • Provides better data about health plan performance
  • Safeguards protected health information under HIPAA

What are the benefits of CareCounsel for employees and their families?

  • A personal healthcare advocate to help them navigate the healthcare system
  • Supports them with health plan selection at open enrollment
  • Helps members find quality doctors, hospitals and other healthcare providers
  • Helps resolve insurance claims and correct billing mistakes
  • Helps prepare for doctor visits and educates about medical conditions, tests and treatments
  • Protects employees’ privacy and confidentiality
  • Lets members anticipate treatment costs before getting care and find the most cost-effective providers
  • Provides support navigating consumer-directed health plan designs
  • Encourages participation in other health management programs like EAP’s, health risk appraisal and wellness, care management and work/life
  • Advocates on behalf of members for healthcare problem resolution.

How does CareCounsel work?

Expert CareCounselors are available to assist employees, retirees and family members through CareCounsel’s toll-free number. Our CareCounselor team consists of master's level healthcare educators, registered nurses, and employee benefits professionals with strong health care experience. Callers speak with a CareCounselor, who handles their case from start to resolution. Members receive their CareCounselor’s direct extension should they wish to bypass the queue the next time they call.

What issues does CareCounsel typically handle?

Our staff serves as a liaison between health care consumers and healthcare providers, insurance plans and other players in the complex healthcare system. We help employees with issues involving medical, hospital, vision, dental, behavioral health, pharmacy and other healthcare needs. We locate primary care doctors, specialist physicians and medical institutions, as well as solve claims, billing and related administrative problems. We also help members understand and navigate the bewildering world of Medicare for themselves or their parents.

What kind of reports does CareCounsel provide?

Our quarterly reports provide comprehensive data categorizing the issues about which members call our program. We report the actual number of people using the program, as well as CareCounselor interventions. Additionally, we provide a closed case problem analysis sorted by health plan vendor and design for all claims, network access and eligibility-related issues. Finally, we tabulate satisfaction survey results, including free text comments, along with objective program performance ratings.

Are CareCounsel's services available worldwide?

CareCounsel only serves clients who are domiciled in the United States, although we do help domestic employees who incur claims while working or traveling overseas.

Does CareCounsel sell other benefit programs like EAP, disease management, wellness and work/life?

No, CareCounsel’s sole focus has always been health advocacy programs. Our advocacy service is comprehensive without additional fees for various service components. We do not cross-market other benefit services.

Does my company need to sign a three-year agreement with CareCounsel to receive services?

No, CareCounsel’s standard group agreement has a one-year term.

Is it difficult to switch from another health advocacy vendor to CareCounsel?

Many of our clients have used other health advocacy vendors, before making the switch to CareCounsel. Our client implementation process is streamlined and takes about 30 days. The Client Services Manager assigned to your group will gather information about your health and ancillary health benefits and oversee our internal benefits loading process, so your organization’s health and ancillary health plan information is available to our CareCounselors when employees call. Your Client Services Manager will work with you to develop a customized communications strategy using a mix of print and electronic media.

How does CareCounsel help save money for clients and members?

CareCounsel saves money for clients by affording their Human Resources and Benefits Department the opportunity to outsource time-consuming health benefits advocacy functions.

For employees, we save time and frustration, which typically translates into productivity savings. Our CareCounselors get to the bottom of healthcare and insurance problems quickly and know how to solve them.

Routinely, we work to resolve billing and claims errors -- another source of savings. We also help negotiate provider fees.

Additionally, we help members anticipate their expected treatment costs using different providers and different levels of care, so they can make a cost-effective decision prior to obtaining treatment. And we can help them get to the right medical provider quickly, avoiding unnecessary visits and testing.

Who are CareCounsel’s clients?

CareCounsel serves a range of clients including for-profit, not-for-profit and governmental employers, unions, third-party administrators and employee assistance programs.

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