Advocacy Team Helps Employee Get Medication Coverage Approval After Two Denials
The Client
Large-sized Company in the Industrial Machinery Industry Operating on a Fully-Insured Plan
The Challenge
The insurance carrier denied a member coverage for a medically-necessary, lifesaving medication – and was again denied after their doctor made an appeal.
The Solution
The employee reached out to their Caravus advocate for guidance. Our advocate was able to use their connections at the group’s carrier to move the employee’s case up the ladder – while simultaneously providing extra resources and updates on the case to the employee should the denial failed to be overturned.
The Outcome
The coverage denial was soon overturned, and our advocate let the employee know as soon as they received the news.
“I’m so glad HR provides us with a great resource like Caravus. Our advocate is fantastic – I’m sure happy she’s part of our team.”