After being diagnosed with a rare, debilitating autoimmune disorder, two dependents needed Intravenous immunoglobulin (IVIG) – a treatment categorized as experimental. Due to its classification, the member’s insurance carrier denied coverage…
Read MoreWhen a dependent is transported from school to the hospital, a member is billed at an out-of-network rate for emergency transportation services. After contacting their Caravus Advocate, negotiations between…
Read MoreA fully-insured client decided to work with Caravus to explore self-funded insurance options. After making the switch to a self-funded model, the group saw significant cost…
Read MoreWhile conducting mid-year audits, the Caravus Eligibility Team noticed there was a newborn dependent that was reaching the end of their 30-day post-birth coverage period. Carriers automatically enroll newborn babies to ensure…
Read MoreDuring their first enrollment with Caravus, the group decided to change medical and ancillary carriers. As the carrier change processed, members who had appointments on the calendar were concerned their new insurance would not be recognized since their ID cards had not come in yet…
Read MoreAn employee and their 3-month-old baby had lost their coverage through the state and struggled to get any answers. Their child needed to go to the doctor, and they were concerned because without insurance, they could not make an appointment…
Read MoreAn employee’s physician ordered a sinus scan, which was to be conducted at their main location residing on a major hospital’s campus. The scan at the doctor’s hospital office was quoted at $876, and the employee wondered if they could get the scan elsewhere at a lower cost…
Read MoreWhen a client’s Medicare Supplement plan was denied due to a misinterpretation of coverage on the facility’s part, the Caravus Senior Advocacy Team stepped into action…
Read MoreAn employee’s child was diagnosed with dyslexia and as a part of their treatment plan, their provider recommended speech therapy, which was listed as a treatment exclusion on the client’s plan, meaning they would be denied coverage…
Read MoreEven after meeting all the necessary criteria, an employee’s surgery coverage was denied. Our advocacy team sent in an appeal, and after many conversations with the carrier’s leagal team and…
Read MoreAn employee who needed knee surgery was advised by this group’s HR specialist to get the surgery through their organization’s new alternative surgical contracting program. Through the program, them employee ended up paying nothing…
Read MoreWhen a life-saving medication was denied twice, Caravus advocates stepped in to ensure this employee’s approval.
Read MoreWhen an employer was notified by Caravus advocates that they were paying for health insurance of many termed employees, our team sprung into action to fix this mistake caused by their previous broker.
Read MoreThis smaller client wanted to provide their employees across the country with great benefits, but because of their size, they needed to be mindful of costs. After moving carriers, negotiating new ancillary contracts, and joining Caravus Connect, the group saw a 40% decrease in…
Read MoreAn employee was admitted to the hospital for an extended stay, during which their company switched medical insurance carriers. After their release, they received a bill for over $30,000, because their insurance was technically canceled during their stay.
Read MoreAn employee with an extremely rare type of Leukemia realized they enrolled in a medical plan that would not cover the specialists they needed to see, nor would cover the majority of their chemotherapy medications. If they remained on their enrolled plan, they would have to cover thousands of dollars for treatment out of their own pocket…
Read MoreA client's employees expressed desire for additional mental health benefits. After implementing an employee assistance program through their current benefit offerings, they were unsatisfied. Caravus recommended the group offer a standalone EAP. When tragedy unfolded…
Read MoreA client enlisted the help of the CaravusRx’s team of Certified Pharmacy Benefits Specialists and Pharmacists to take a deeper look into their current pharmacy benefits contract. After review, the CaravusRx team discovered their current PBM contract contained clauses that were responsible for the rising pharmacy costs.
Read MoreA member’s dependent needed a specific type of insulin that unfortunately was excluded under their plan. In order to receive their medication, the dependent requested their medical care provider send an appeal to their insurance carrier. Unfortunately, the appeal was denied…
Read MoreA client’s employee ordered a CPAP machine from a provider that was listed by their carrier as in-network, but later found out that only a certain division of that provider was in-network…
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