Case 1
PATIENT: 22-year-old male
CONDITION: MVA requiring extensive reconstructive surgery requiring implants
BILLED: $1,718,432.67
PAID: $232,782.15
SAVED: $1,485,650.52 (86% discount)
PROVIDER: HOSPITAL IN COLORADO
This patient suffered a number of extreme injuries following a serious motor vehicle accident while on holiday. He underwent extensive surgery including a reattachment of the leg at the hip, and was admitted for 85 days. The policy had a maximum benefit of $1M, which included both medical benefits as well as long-term care benefits. By securing a deal based on Medicare rates, AF24 was able to preserve the bulk of the patient’s benefits for continuing treatment after discharge.
Case 2
PATIENT: 45-year-old male
PROCEDURE: Knee Arthroscopy
BILL 1: Surgeon - Billed: $20,000.00; Paid: $2,219.83
SAVED: $17,780.17 (89% discount)
BILL 2: Assistant - Billed: $4,000.00; Paid: $164.27
Saved: $3,835.73 (96% discount)
PROVIDER: SURGEON AND ASSISTANT IN TEXAS
The patient underwent a simple knee arthroscopy following a fall. The negotiator proposed a settlement based on the state workers compensation fee schedule even though the patient was a non-subscriber to the Texas Workers Compensation program. Following several conversations with the provider, they ultimately signed off on the agreement, saving the client in excess of $21,000 on charges of $24,000.
Case 3
PATIENT: 39-year-old male
PROCEDURE: Laminectomy, Facetectomy
CHARGES: $17,392.00
PAID: $3,099.57
SAVED: $14,832.43 (85.3%)
PROVIDER: SURGERY CENTER IN ARIZONA
The patient underwent spinal surgery to relieve chronic pressure from a hernia. Charges were approximately 6 times the Medicare rate for the procedure, and the AF24 negotiator submitted a proposal based on Medicare. The original contact AF24 liaised with was resistant to the proposal due to the level of discount AF24 was seeking on behalf of our client, and the hospital was requesting nearly full-billed charges. The AF24 negotiator was not willing to accept such a large overpayment and escalated the case to a director in the provider’s business office. After speaking with the director and outlining our arguments, the provider ultimately signed off at just above the Medicare-allowed rate.