HOSPITAL & HEALTH ADVOCACY

  • Bill Negotiator

A dedicated patient advocate works directly with a member’s healthcare provider to help reduce their out-of-pocket portion of medical bills. To be eligible for Bill Negotiator, you must be an active member of CareClub24 and your out-of-pocket balance from such medical services must exceed $1500.

  • Surgery Saver

Surgery costs can vary greatly from facility to facility, and in our experience, we have seen a 66% cost difference for the same surgical procedure with no appreciable difference in quality. A dedicated advisor shops up to five surgical facilities to verify the best available price, quality and availability for non-emergency procedures, as well as physician privilege verification.

  • Healthcare Navigator

Karis360 Advisors are available to address healthcare questions, concerns, and needs. The caring Advisors at Karis360 assist in physician selection, controlling prescription costs, and healthcare facility searches, as well as health cost estimates, alternative medicine options, lab and imaging services and affordable care act questions, and more.

What is the Patient Advocacy Program?

The Patient Advocacy Program is designed to help members with their medical bills whenever a related medical incident includes a hospital or similar facility charge. CareClub24/AmeriPlan has contracted with The Karis360 Group, one of the largest Hospital/Patient Advocacy organizations in the country…

How the Hospital/Patient Advocacy Program works:

  1. Once you have been advised by your physician that a hospital occurrence will be necessary, you will need to contact AmeriPlan at 1-866-977-2477.
    The total cumulative medical costs per incident must be at least $1500. (For the insured, this means the amount you are personally responsible for, aside from your deductible.)
  2. If this requirement is met, the member will be transferred to the Patient Advocacy Coordinator. (In order to open a case for scheduled services at a hospital or surgical facility, at least a five-business day advance notice is required.
  3. If admission is scheduled and the Member has a written estimate from the hospital or surgical facility Karis360 will provide the Member with relevant information about cost and payment options.)

To learn more, see our FAQ’s…

What is the Hospital Advocacy Program?

The Patient Advocacy Program is designed to help members with their medical bills whenever a related medical incident includes a hospital or similar facility charge. AmeriPlan has contracted with The Karis Group, one of the largest Hospital/Patient Advocacy organizations in the country.

Karis is not insurance and does not provide funds to pay for bills. This is a best- efforts service. Results cannot be guaranteed.

How do I use my CareClub24 Hospital/Patient Advocacy Program?

  • Once you have been advised by your physician that a hospital occurrence will benecessary, you will need to contact AmeriPlan at 1-866-977-2477.
  • You will be asked a variety of questions to determine the nature and scope of themedical incident.
  • The total cumulative medical costs per incident must be at least $1500. (For theinsured, this means the amount you are personally responsible for, aside from yourdeductible.) If this requirement is met, the member will be transferred to thePatient Advocacy Coordinator. (In order to open a case for scheduled services at ahospital or surgical facility, at least a five-business day advance notice is required. Ifadmission is scheduled and the Member has a written estimate from the hospital orsurgical facility Karis will provide the Member with relevant information about costand payment options.)
  • Medical costs that pre-date your active date may be negotiatedthrough Karis if they meet or exceed $1500. There is a non-refundable flat fee of$250 that must be paid to The Karis Group before negotiations begin.
  • The member will receive a medical release form which must be signed andreturned to The Karis Group. If the form is not signed, it may delay the processingof your paperwork.
  • An Advocate from The Karis Group will contact the member to determine thebest course of action to obtain the best care at the lowest available cost.
  • If a member visits the hospital on an emergency basis, a Patient Advocatenegotiates with the hospital on a post-confinement basis.
  • There is a three (3) business day waiting period from the active date of yourmembership to access any hospital advocacy service. Member must remain in“Active” status during the entire hospital advocacy process.

If you have not been contacted by The Karis Group within 5 -7 days please contact the AmeriPlan Patient Advocacy Coordinator at 1-800-256-3368 x4340.