Advocacy Services

With today's health and welfare programs becoming increasingly more difficult for employees to understand, the burden on HR to resolve health plan issues is amplified. Through ADP's Advocacy Services, specially trained experts can help employees resolve health care coverage and care disputes.

Your HR staff could exhaust themselves obtaining referrals, understanding formulary restrictions, accessing appropriate care, and resolving participant billing discrepancies. In contrast, ADP's advocacy team consists of individuals with medical, health plan, mediation, research, and customer service backgrounds. They are equipped with the tools to provide:

Enrollment discrepancy resolution
Claims dispute mediation
Coordination of benefits discordance resolution
ERISA/HFCA adherence and conformity
Medical case review
Qualifying event appeals
Prescription drug formulary appeals
Reasonable and customary disallowance issue resolution
Medical necessity advocacy

Your organization will save the time spent researching health care issues, and the costs associated with training your employees to become experts. At the same time, employees will rest assured that they are in good hands.