Nick’s Story
This is a section where we give a voice to patients, providers, advocates and healthcare experts.
Nick is possibly the last person you’d imagine turning to Better because he’s a doctor. If anyone should be able to navigate the insurance system it should be Nick. He’s mid-thirties, tech-savvy, articulate and educated. He works in and understands the healthcare space. Familiar with the processes, he speaks the language of “allowable charges,” “out-of-network billing,” and CPT codes. But he still couldn’t get the money he was owed.
He works for Kaiser and experienced the difficulty of trying to get reimbursed four years ago. “I tried to submit claims in the past and the process was so painful. I didn’t understand how to fill out the forms. There was data missing. My claim was rejected. I had to go back and get more information from the therapist. The phone calls were endless. I remember it being a nightmare. I didn’t want to have to deal with it. I got so frustrated with the process that I stopped seeing that therapist.”
This is a common experience. People try to submit a claim, get nowhere and give up. They are left with three bad choices; they can accept inadequate in-network care, pay the full out-of-network cost, or forgo care. “Before I discovered Better, I was avoiding finding a proper psychiatrist because I didn’t want to deal with out-of-network, so I stayed in-network with limited choices.”
Better was able to help with Nick’s therapy claim because our technology automates the process, correcting billing and coding errors, making it difficult for the insurance company to reject claims. Better resubmitted the claim to Kaiser, received an E.O.B. (explanation of benefits), then transmitted that data to Cigna, letting them know that the primary insurance would not cover this claim. Our technology makes this simple.
Better made sense for Nick and he has already gotten his money back from his insurance. “Better did everything and Cigna actually paid up. It was quite a process but Better was super-easy to use and really well designed. You just go in, open the App, take a picture of your bill and hit submit. I just got a new out-of-network psychiatrist, paying out-of-pocket, and I most probably wouldn’t have been willing to do that if it weren’t for the fact that Better exists — and I’m perfectly serious about that.”
