Recently a patient was admitted while in critical condition and in dire need of cardiac treatment. The doctors recommended a procedure that usually involves huge costs but considering the patient’s condition, the procedure seemed to be the only feasible option.
The patient’s attendant (in this case, his son) then made a cashless approval request to the Insurance Company in order to go forward with the procedure that was to be performed on an urgent basis.
Usually such a request requires an average time period of 4 hours before the Insurer can revert back.
What caused the delay in the cashless claim approval?
In this case, miscommunication occurred between the Insurer, Insurance Coordinators at the hospital and the patient’s attendant. When a query was raised by the Insurer as to why this procedure had been selected, the query was neither responded to by the Insurance Coordinators at the hospital nor was it communicated to the patient’s son.
Due to this lack of communication, an entire day passed by before the son was informed that the claim was not yet approved. It was after this major delay that the son reached out to one of Nova’s employees for guidance. The insurance in question was provided to the patient by a company he had previously worked in.
How did Nova Benefits lend their support?
At this point, the Nova claims support team got involved and advised the son on the optimal next steps. With our support, the query response was followed by an escalation for urgent resolution.
Eventually, the cashless request was approved approximately 2.5 hours after Nova got involved in the process.
Even though the procedure was done after a massive delay, Nova was able to provide solutions to help the patient and his son during a dire time. Nova has also provided advice to the patient’s son in order to ensure that he gets the maximum amount through the Insurance Claim.
We at Nova Benefits would be happy to extend our claims concierge service free of cost to anyone in an emergency. Please reach out to us in case of any queries.