"[T]his appeal process taught me to ask questions (sometimes more than once), investigate where a process can go wrong, and hold people accountable for the information they provide.”Hailey Frye
Students in weekly Collaborative Advocacy Session
“Persistence”: Student Advocacy for Insurance Coverage
Many of our undergraduate and gap year students go onto medical school. We recently heard from Hailey Frye: “I am thoroughly enjoying my first semester of medical school at the University of Minnesota- Twin Cities! One of my courses, Medical Arts and Social Sciences, helps us learn more about the healthcare system outside the exam room. We discuss insurance, healthcare legislation, and how to improve system quality. I get to share what I learned during my time at CPP and hope the knowledge will help future providers advocate with their patients.”
When Hailey was an advocate at CPP, she worked with a mother facing a concerning cancer diagnoses while still supporting several kids. The client reached out to CPP after receiving bills with out-of-pocket costs over $10,000. Hailey identified that insurance was not applied. She shared the following reflection:
“The many phone calls I had with insurance representatives reminded me to balance my optimism and pessimism about the insurance appeal process….After waiting the 30 days [for the appeal], the insurance representative told me their fax system didn’t ‘grab’ the fax and that the appeal wasn’t on file…. I sent the fax again, making sure to check that they received the document. I called the appeal department every week for 3 weeks and the representative said the appeal was processing. On the 30th day, the representative said only one of the 30 claim numbers had been entered. I sat on the phone as she entered the other 29 claim numbers.
At this point, the 30-day appeal timeline was now scheduled to take 90 days. During each check-in with the insurance company, I learned which questions to ask, how to be direct without being rude, and what I should include in my updates to my client without setting unrealistic expectations….[T]his appeal process taught me to ask questions (sometimes more than once), investigate where a process can go wrong, and hold people accountable for the information they provide.”
In the end, all 30 claims were reprocessed due to the student advocates persistence.and the client’s out-of-pocket costs went from over $10,000 to nearly $700! Saving over $9,000 for this client made a significant difference.