Resolve participant access to care or claim disputes with employer-provided health plans.

Employees often find it confusing to sort out the complexity of today's health care plans. They need information on access to care, and claims issues from medical to vision, prescription drugs to Medicare. Sometimes employees turn to HR for help in addressing these complicated and time-consuming problems, putting more pressure on an already lean HR staff. Other times, employees leave troubling issues unresolved simply because they're reluctant to share sensitive health information with HR out of fear that the information might impact an employment decision. Hewitt's Advocacy Services help solve these issues. 

We provide advocacy for nearly 4.5 million participants at a wide variety of client organizations. Advocacy Services help employers:   

• Reduce the time HR staff spends on escalated issues
• Operate within HIPAA's privacy rules and eliminate perceptions that an employee's health problems could factor into employment decisions
• Lessen the participant frustration in resolving issues and increase satisfaction and appreciation of benefit plans 
• Resolve issues within the plan's ERISA-compliant deadlines by which participants must file claims 
• Improve employee productivity by helping them resolve distracting plan-related problems
• Identify trends and track health plan performance

Hewitt Advocates are experienced in claims processing and knowledgeable about provider billing practices, medical terminology, and accepted industry standards. We've escalated contacts at insurance companies and use those contacts to get fast resolution. Our goal is 24-hour resolution for critical issues and five-day resolution for noncritical issues. The turnaround time is often affected by responses from third parties—but even in those situations, our Advocates provide consistent follow-up to ensure the fastest resolution possible. 

Advocacy Services also provide detailed reporting that helps employers identify the root cause of recurring issues that may indicate a need for comprehensive plan adjustments. Reporting can also measure the impact of recurring issues and measure how much time and money companies saved as a result of making adjustments. Additionally, reporting can measure the increase of employee satisfaction levels as a result of Advocacy Services. These are only a few of the issues our reporting may address.

Hewitt's services include:

• Tier 2/trained specialists/specialists with enhanced training
• Enabling/assisting with access to prescription drugs
• Research and resolution of billing issues and unpaid claims
• Referrals to health and wellness programs
• Education for annual enrollment choices in employer and Medicare plans      

Having trouble resolving your own tough health care or retirement benefit issue? A Hewitt Advocate can definitely help. Employees at companies who employ Hewitt Advocacy Services save time, save frustration, and often, save money. Click here to find out how.

To learn more about Hewitt Advocacy Services and how your company can benefit, contact your local Hewitt consultant or e-mail peoplesolutions@hewitt.com.

Case Studies
Halliburton Helps Its Employees Resolve Claims Issues
By redirecting claims inquiries to Hewitt, Halliburton employees are able to focus on priorities.
view the case study

NiSource Streamlines Benefit Claims Investigation Process
Using a variety of specially designed tools and processes and an experienced, highly trained team, NiSource dramatically improved its claims resolution process.
view the case study