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YEAR-ROUND BENEFITS AND HEALTH CARE SUPPORT
saving money & Earning rewards
UNDERSTANDING YOUR BENEFITS
supporting health care
reviewing medical bills
finding a doctor
resolving claims issues
Advocacy is a confidential, no-cost service offered by your employer to help you and your covered dependents save money, maximize your benefits and make the right choices for your unique situation. We work for you, not an insurance company or provider.
How we can help
HOW CAN Optavise help me
A success story
WHAT People ARE SAYING
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Maria was new to her company, and to benefits. She had information about her options but didn't understand all the terminology. What was the difference between a deductible, coinsurance and copay? Maria knew she had Optavise to help with benefits questions, so she called an Advocate. Maria's Advocate answered all of her questions using terms she could understand, so she could make the best choices for her personal needs. When Maria got married later that year, she wasn't sure how to add her spouse to her benefits. She called her Advocate, who was able to explain the steps Maria needed to take. She successfully enrolled her spouse and enjoyed the confidence of knowing nothing had been overlooked. Now Maria calls Optavise when she has any benefits or health care question or decision to make. Her friendly Advocate takes the burden of researching and deciphering the jargon off her shoulders!
I tried my carrier and was on hold for 25 minutes prior to hanging up. I called Optavise and had my answer within five. My advocate was very helpful, friendly and knowledgeable.
"Benefits and health care can be confusing" may be the understatement of the century. Your Advocate can help. We'll answer your questions in plain language. BRING YOUR QUESTIONS: How do my benefits work? What’s the difference between copay and coinsurance? Is that specialist in my network? How do I get a new ID card? Is there a less costly option for my test or procedure? Is my dependent covered? How can I save money on my prescriptions? Why was my claim denied? Is this medical bill correct? Who can help me understand a new diagnosis and treatment plan? Your Optavise Advocate will provide the answers.
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understand my benefits?
A success story: Maria
WHAT PEOPLE ARE SAYING
HOW CAN ADVOCACY help me
A success story: tom
Tom, a high school teacher, needed an MRI. Before scheduling an appointment, he called Optavise to request a cost comparison. Optavise gathered his information and within a couple days Tom received a report showing three providers with a cost saving difference of about $2,000. With those numbers, he was able to choose the lowest-cost facility to have his MRI done. The MRI determined he would have to go in for knee surgery, so Tom went back to Optavise for more assistance. They compared two hospitals where the same doctor performed the same knee surgery, and the cost difference was almost $8,000! By working with Optavise to understand his options, and choosing lower-cost options for high-quality care, Tom saved $10,000 on his medical bills for the MRI and the surgery - and even earned a reward for doing so!
Optavise has now searched for lower cost providers four times. And four times I've been rewarded for choosing the lower cost providers. Fantastic service!
Who doesn't want to save money? Optavise will track down every opportunity for you to save on health care costs. You can even earn rewards for making smart health care choices! COST TRANSPARENCY & REWARDS Medical test or procedure coming up? Call Optavise before you schedule it to receive a free report showing cost and quality information for up to three providers in your area. Choose a lower-cost option and you could earn a reward*! Call Optavise to receive a cost comparison report for nearly any medical test or procedure, including mammograms, colonoscopies, X-rays, ultrasounds, MRIs, CT scans, surgeries and more. Optavise will explain the details of how the rewards program works. OTHER WAYS TO SAVE Optavise can also: Look for ways to save on your prescription medication costs Review your medical bill for errors and expedite corrections Find and in-network doctor to ensure you get in-network pricing Appeal denied claims
SAVE ON COSTS?
HOW CAN DIRECTPATH help me
*You are eligible for one reward payment per CPT code per calendar year. Reward payments are subject to tax.
Who doesn't want to save money? DirectPath will track down every opportunity for you to save on health care costs. You can even earn rewards for making smart health care choices! COST TRANSPARENCY & REWARDS Medical test or procedure coming up? Call DirectPath before you schedule it to receive a free report showing cost and quality information for up to three providers in your area. Choose a lower-cost option and you could earn a reward*! Call DirectPath to receive a cost comparison report for nearly any medical test or procedure, including mammograms, colonoscopies, X-rays, ultrasounds, MRIs, CT scans, surgeries and more. DirectPath will explain the details of how the rewards program works. OTHER WAYS TO SAVE DirectPath can also: Look for ways to save on your prescription medication costs Review your medical bill for errors and expedite corrections Find and in-network doctor to ensure you get in-network pricing Appeal denied claims
DirectPath has now searched for lower cost providers four times. And four times I've been rewarded for choosing the lower cost providers. Fantastic service!
Read a testimonial from a harsco employee!
a success story: Mohul
Mohul received a scary-sounding diagnosis. After meeting with his doctor, he still had many questions - so he called Optavise. Optavise's registered nurse explained the diagnosis and possible treatment options in plain language, and answered all of Mohul's questions. She was also able to assist with identifying a provider for a second opinion. Later, she helped with setting up ongoing tests and appointments, and coordinating between the insurer and multiple providers. She also arranged for Optavise to review all the medical bills to ensure accuracy. In this process, two medical bill errors and one mishandled claim were identified and corrected, saving Mohul hundreds of dollars he may have otherwise had to pay. Optavise offered peace of mind and personal assistance with managing this complex care case and its related billing issues, allowing Mohul to focus on his health and recovery.
On my own, it took me four months to get the insurance carrier, medical providers, and pharmacy talking to each other to get approval for my procedure. After contacting Optavise, the issue was resolved within 24 hours.
SUPPORT my HEALTH CARE?
A new diagnosis, complex treatment plan, or care coordination can be confusing to understand and difficult to manage. Or maybe you just have a simple health-related question for a medical professional. Optavise's team of registered nurses is here to help. Call Optavise for help with: Any health care related questions or concerns Understanding a diagnosis or treatment plan Chronic condition management Coordinating with multiple providers and insurers Prior authorizations and pre-certifications Finding a doctor and making appointments Getting a second opinion Finding lower-cost prescription drug alternatives Scheduling tests and appointments
HOW CAN OPTAVISE help
a success story: PAUL
Paul had an unexpected hospital stay as a result of an accident. Afterward, he received a bill in the surprisingly high amount of $74,000! Paul called Optavise immediately. Optavise reviewed the bill and found incorrect billing codes and mishandled pre-authorizations. Optavise then worked with the provider and insurance carrier to correct the issues and come to a resolution, resulting in a much more reasonable bill of $3,700. But it didn't end there. Upon reviewing Paul's elected benefits, Optavise confirmed that Paul had signed up for his company's hospital indemnity plan. After filing a claim, he received a $3,300 check which he used to pay down the balance on his bill - leaving him with a total out-of-pocket cost of $400. Paul was very relieved, and Optavise was thrilled to help another happy member save money.
I had a question about external billing for a medical procedure I recently had done. The advocate reached out to my insurance provider, and confirmed everything was as it should be.
find medical bill errors?
Errors in medical bills are unfortunately quite common, and the coding used can make it extremely difficult to understand the bill. Luckily, Optavise is fluent in health care and insurance coding and jargon. Call Optavise the next time you receive a medical bill you're not sure about. We'll provide a quick, no-cost review. If errors are found, we'll work to have them corrected so you don't pay more than you should.
HOW CAN OPTAVISE help me
a success story: LIN
Lin's doctor told her she needed to see a specialist for a procedure that required a pre-authorization. Her doctor completed the pre-authorization process, but after the procedure Lin received a denied claim notification along with a hefty medical bill. She called Optavise right away. Optavise worked with the provider and insurer to verify the pre-authorization was completed correctly and had simply been misfiled. They also reviewed Lin's medical bills and discovered a duplicate charge that had been entered in error. After the appropriate correctioner were made, Optavise had saved Lin time, frustration and more than $5,000 in charges she should not have been responsible for.
I was stressed before I called Optavise and I didn't want to deal with my insurance company. All I had to do was pick up the phone and dial. Optavise took care of everything else.
resolve claims issues?
If you receive a denied or mishandled claim for services that should be covered by your plan, there's no need to spend hours on the phone with your insurer or provider's billing office. Simply gather your paperwork (bills, explanations of benefits, etc.) and call Optavise. We will review all elements of your claim to identify if a mistake was made, and work to correct it.
a success story: shanna
Shanna had a new job in a new city, and her entire family needed new doctors. She needed a primary care physician and an OB-GYN. Her husband needed a primary care physician and a physical therapist. Her two kids needed pediatricians, and her daughter required care from numerous specialists. With the stress of the move and the new job, this task felt overwhelming. Luckily, Optavise was part of Shanna's benefits package. Shanna called Optavise and let them know of her needs. They identified a number of high quality, in-network providers who were accepting new patients. She was able to choose the best options for her family, and Optavise even set up the appointments they needed! Shanna was relieved.
I needed a second opinion and wasn't sure where to start. Optavise gave me a list of doctors that fit all of my criteria, and even made appointments on my behalf!
FIND A DOCTOR?
Don't waste hours searching online, asking friends, or calling numerous offices to find a doctor. All you need to do is make one call to Optavise. We can help you find top rated in-network providers in your area. Need a specialist? We can help with that too, and can arrange for necessary referrals or pre-authorizations. Want a second opinion? Call Optavise and we'll find one for you. We can even make appointments on your behalf!
"My dependent and I both had to have MRIs this year. If you’ve never had one, they can be very expensive! With the help of a Optavise advocate we were able to find a local, qualified provider and saved so much money. The reward was an extra bonus and I was shocked, and thankful, at how much it was. If you are not using this free service, you are leaving money on the table. And who can afford to do that these days? I will continue to reach out to them for any upcoming medical test or procedure. Optavise is a game-changer and who doesn’t need or want support navigating healthcare?"
HARSCO EMPLOYEE
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