Page 26 - Venafi - 2021 Benefit Guide - CA
P. 26
your team member advocate is here for you
Our Team Member Advocates will work with you and
your providers to ensure that each party gets their
questions answered and problems resolved.
Our Team Member Advocates can:
• Work with carriers on billing and claim payment issues for team
member medical, dental, vision, and life insurance
• Coordinate between the pharmacy and the health plan for
escalated pharmacy issues
• Explain network access and payment process for in and out-of-
network providers
• Work with providers to file paperwork if claims have been
denied due to lack of required authorization
Diversified Insurance has • Clarify the total and out-of-pocket cost for services provided
a dedicated team member • Assist with referrals and prior authorizations
advocacy team to help resolve • Help with all levels of appeals
claims problems, enrollment • Ensure services are being coordinated when multiple doctors or
coverages are involved
complications, and other service • Help gain access to care and services
related issues. • Define preventive care and associated guidelines
• Assist in finding a specialist for a condition or diagnosis
Contact your Team Member Advocate • Explain benefit plan details and coverage provisions
(801) 325-5075 | (888) 244-1212 ext. 5075
[email protected]
23
23
