Pursuit of Excellence—Patient Advocacy Program Helps DFW Employees
Finance Department Controller Debra Sanford, found herself in a predicament after receiving dental services from former DFW health care provider Humana.
Once her work was completed, Sanford discovered that a portion of her dental claim, which amounted to several hundred dollars, was being denied. Despite repeated calls to the provider, Sanford said the bills continued to pile up and her dental office was getting impatient.
“It was the end of the year and I knew that DFW was transitioning to another health care provider and I was concerned,” said Sanford. "My dentist called the provider and they were not going to pay, so I called Pursuit of Excellence (POE) to see it could get assistance."
She said that shortly after she contacted POE, she received a call from a representative to discuss her case.
"It wasn’t even 24 hours and she called me up and said the dentist put the wrong code in when he submitted the claim, and that was why my claim was being denied," she said. "The POE representative knew the codes."
Irene Clark, senior workforce engagement and communication manager, said patient advocacy programs can save employees time and money.
“A few years ago, my son took a nasty tumble and cut his head," said Clark. “When we took him to the emergency room we discovered he also broke his wrist. Then the bills started to come in and I didn’t have time to research my medical coverage to make sure was boing charged appropriately.”
Clark said she decided to give DFW’s patient advocacy program a try.
“I contacted DFW’s advocacy program and they reviewed my bills and verified my coverage and I ended up saving hundreds of dollars. It’s such a valuable benefit to employees,” said Clark.
Pursuit of Excellence Senior Human Resource/Benefit Consultant Heather Howell said POE serves as a liaison and assists employees in resolving health care related issues more quickly.
"People are smart but they don't always have the time or knowledge to navigate the system,” said Howell. "We assist clients with claims and billing issues including pharmacy, and provide many other valuable services to make the process easier.”
Pursuit of Excellence helps employees to:
- Choose a medical plan
- Locate a doctor or dentist in your network
- Understand the cost of a procedure or test
- Obtain authorization and referrals
- Understand your benefit options