Carter Freeman
The craziest thing I’ve ever done is drive one of our client’s employees to the hospital. I received a call from her. She had surgery planned but her son’s flight was delayed and she had no other ride. I drove over to her house, picked her up and took her to the hospital. She and I checked her in and I waited until her son was able to get there before I left. I was grateful to support her, her family and her company. I’m happy to report that she made a full recovery.
Stacy Sedberry
A client decided to change carriers only a couple of days before their renewal date. This left very little time to have a normal enrollment but I was determined to make it as smooth as possible. Through teamwork, we got the group installed in record time. I finished the last part of the install at 2 AM. It was a lot of work but I was determined to make sure their employees were covered. The human resource manager still brags about how quickly we pulled this off.
Brent Young
A CEO called me after hours asking what his deductible was. I told him the amount and asked why? His wife was having stomach pains and wanted to go to ER that he didn’t want to pay for. He thought she was being overdramatic. We called the carrier’s nurse hotline together, and it ended up she needed an emergency appendectomy! One question saved him thousands in medical bills!
Leighann Lubbock
We had a client that was extremely concerned for the welfare of her adult son who had fallen victim to substance abuse. Not knowing what to do she called me around 7am for guidance. I immediately found the best facility in Houston, called the insurance carrier and and the facility to organize everything. I sent his ID card to the facility and was able to provide that facility with all of the insurance information required to complete their pre-authorization requirements. By the time the family arrived there was a bed ready and waiting for him with no wait. It was one of the most rewarding experiences I’ve been a part of with my clients!
Michael Andrade
A client moved to a reference based pricing approach for their benefits program with Smart Shopper options (100% coverage $0 Deductible $0 Copays). I gave my personal cell number to all employees and their family members and challenged them to call me with any problem that they have or if they’re at the doctors office to call me personally if they’ve any problem. I also offered to call their doctors and other providers in advance of their visits to make sure the doctor knew what to expect. As a result, I negotiated with one of the largest physician practices in town, curated value with the hospital systems, negotiated directly with MD Anderson, created certainty with the employees and their families, and drove their healthcare costs down 40% while improving benefits. Giving my phone number was huge as the audience experienced a “mic drop” boost of confidence. Watching this employer go from powerless to empowered was a huge gift of gratitude as well. ”
A Trucking client was trying to figure out a way to engage employees and their spouses well after open enrollment and also because the spouses make most of the healthcare decisions. We created a marketing platform whereby employees receive emails/texts about how their benefit program works and we completely automated their open enrollment communications. All new hires receive a welcome video from the CEO inviting them to use the Smart Shopper Programs and they get a text a day (10 days) about a unique feature for how to save money on healthcare through Smart Shopper options. Further they can sign their spouses and college age kids up for email/text notifications as well. The great thing is that they use this service as an alert for COVID, Safety Alerts, and other company initiatives where mass email/texting helps to deliver a consistent message.
Kim Lauderdale
I once had an employee who was very distraught call me. Her child recently had a transplant and she could make no sense of the bills that were coming in. She told me they were too much to email or fax so I sent a courier to pick them up. When I saw them, I realized why she was distraught. She had almost $800,000 in bills that were about three inches thick. I spent the next couple of days working to make sense of everything. In the end, she owed nothing more than she had already paid and was very thankful for someone giving her comfort in such a stressful time. I’m happy to report that her child made a full recovery.
Chrissy Benton
This week I was asked what the craziest thing I ever did for a client. Narrowing it down to one story is really hard because after nearly seven years there is a lot to choose from! There is one situation though that sticks out in my mind. Earlier this year one of our client’s employees had a stroke and as a result was hospitalized for a few weeks. His home life was not a normal situation. In fact, he didn’t have a home. He had worked on and off for this employer for a while and it was believed that he had some mental difficulties. At first the client just thought that the employee just didn’t come to work and after several unanswered phone calls they could not locate him. It took several weeks to find out that he was hospitalized. During this time the client changed insurance carriers., which was terrible timing. We started short term disability paperwork but in the process the employee passed away. As we normally do, we gathered the necessary paperwork, reviewed his beneficiary information and contacted the new carrier. His beneficiary was his sister who lived in another state and took a two-day bus ride to get to Houston after her brother’s death. It was a terribly sad situation.
What was sadder was that the new insurance carrier didn’t want to pay the claim. They felt that the prior carrier should hold the responsibility. Since the employee had been in the hospital for a while due his stroke, he was not considered an “active employee” and so the new carrier didn’t want to pay the claim. For over a week we went back and forth with the carriers trying to get some closure while the man’s body was at the funeral home. This man and his family were caught in the middle of an insurance nightmare. Daily I made calls and sent emails to the carriers and tried to get a straight answer from someone. At the end of each business day I had to call the sister and share that there was no news. After a few days of this nonsense, I called the funeral home and found out that they needed about $800 to take care of the man’s body, but the sister just couldn’t swing that financially and time was running out. She needed to get back home and the funeral home was running out of patience. To compound matters the funeral home said that without payment secured they would not release the death certificate. Without a death certificate no insurance company was going to pay a death claim, even in a normal situation. It was awful.
After much internal discussion we decided that we would get assignment from the beneficiary and take responsibility for the $800 so that the man’s body could be taken care of. I called the funeral home and they agreed to our deal but wanted it in writing. By this time, it was nearly 6 pm and the sister was scheduled to leave at 4 am the next morning for another arduous two-day bus trip back home. One of my coworkers is a notary and offered to drive with me to meet the sister (who had no transportation) to sign an assignment of benefit document so that the funeral home would release the death certificate to us. Off we went. We met the sister in a parking lot of a local grocery store that the sister walked to. Leighann verified the sister’s identity, she signed the document, the notary seal was applied, and all of this done on the hood of my car! This was a shot in the dark and the sister begged me for confirmation that this would work. She was crying at the thought of having to leave the next morning without closure for her brother. We all felt her pain and I felt like I was failing her. I drove back to the office so that I could send the notarized letter to the funeral home. Within minutes I had the death certificate sitting in my email.
We had already filed death claims with both companies, so I fired off an email that explained what we had done along with the death certificate and prayed that one of these carriers would take responsibility. The next morning my heart sank when one of the carriers called to tell me that brokers could not accept assignment of a death claim. UGH!! What in the world were we going to do? I had one last chance. If I could get the original carrier to flat out deny the claim, then maybe the new carrier based on “continuity of care” would accept responsibility. I gathered the policy documents, bills of both carriers showing the member’s status and requested a formal declination. That afternoon I received it and forwarded it to the new carrier and respectfully requested that they review this case one last time. By this time the sister was into her second day of her bus trip home and I knew that my phone would be ringing soon with her call and it did. I still had no news to give her and her voice on the other end of the phone was heartbreaking. It took two long stressful days but the new carrier, based on the policy documents, the death certificate and the written denial decided to pay the claim! When I called the sister to tell her, she was overjoyed and broke down crying again. Finally, her brother could be at peace.
Crazy is probably the wrong word to describe this situation, but it does reflect the lengths we will go to for a client and their employees to always do the right thing.
