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Helping a member resolve a denied treatment claim

October 12, 2023 | 1 min read

Nearly 25% of people taking prescription drugs have difficulty with the cost of their medication. [1] Being unable to afford prescriptions can affect adherence and overall health. So, when a 49-year-old member who’d been diagnosed with Multiple sclerosis (MS) had her treatment claims denied, the Accolade team went to work for her.

Ten months into treatment, despite prior approval, the member couldn’t get her long-term medication authorized. Our specialized claims and benefit team contacted the health plan to find the problem. This led to an appeal, which helped the member get the care she needed and saved her tens of thousands of dollars.

“By simply making that first phone call, this member was able to impact all of her future healthcare needs,” said Cathy Shorn, Accolade steward.

Watch the video to hear the full story.

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