Financial Advocate

From the Desk of Tamika Chambers

Share this post
Facebook
LinkedIn
Email

From the Desk of…

Tamika Chambers

Cancer Care Services’ Financial Advocate

Human error happens all the time. We know that. But it can seem to occur frequently within the context of medical billing and coding, and when it does, knowing the appropriate questions to ask insurance providers is key. Just consider this example from a few months ago, when a local cancer survivor became the first client to utilize Cancer Care Services’ new Financial Navigation program.

Like many others, this client’s medical expenses had piled up quickly, creating too much of a burden to juggle single-handedly. We sat down together and, after some work, devised a comprehensive path to get them over the top and on the other side of this mountain of financial stress. Together, we labored through more than 200 medical claims. Among them, we identified 67 denied claims that we thought warranted a closer look.

Over the course of two weeks and countless calls to insurance representatives, we worked to understand the client’s insurance company’s Explanation of Benefits statements. I asked why each claim was processed in the manner it was, and I shared the answers with the client, to give them a clearer understanding of their insurance coverage.

During this extensive evaluation period, we discovered one $1,000 claim that had been denied as “not medically necessary”.  But in fact, an identical claim had been processed – and paid – weeks later by the same insurance company. Investigation into the initial, denied claim revealed that it had simply been coded incorrectly and was, after all, a covered benefit under the client’s policy. The claim was reprocessed and the client’s bill was adjusted accordingly.

In addition to reviewing current insurance claims, the financial navigation process dealt with older medical debt that had already been sent to collections, too. Debt validation letters were sent (to verify the details of what is owed) and, as a variety of disputed debts were resolved, the client’s FICO score improved. What’s more: two medical debts tallying greater than $800 were wiped clean!

Currently, work continues to reduce their residual debt, creating the opportunity for them to look toward and begin the next phase of our plan: saving for the future. This is a huge victory for our client! 

An improved credit score, deletion of two medical debts, and getting a claim reprocessed by her insurance carrier represent so much more than an umbrella, giving them shelter from the downpour of financial toxicity, it’s more like the sun has come out on a brighter day. Together, we weathered the storm.

Recent Posts
Camp Gold 2022 participants pose by the lake.

Camp Gold 2022: Healing and Girl Power!

Young adult cancer patients and survivors had so much fun in the sun at Camp Gold 2022! This year was magical and full of girl power! What is Camp Gold?

Marilyn Kepner was chosen as volunteer of the month for National Volunteer Month.

Celebrate National Volunteer Month!

What is National Volunteer Month? April is National Volunteer Month! Cancer Care Services is celebrating our volunteers all month long with thank you videos from our staff. (Watch the videos

Clients wait for Encanto to start at the March 2022 Connect Night.

Encanto Under the Stars

March 2022 Connect Night “I love it!” One of our youngest clients of the night had a blast at the Encanto-themed selfie station! Thank you, Selfie Factor FW, for setting