Bear Mountain (3)

On Top Of The Mountain

I have struggled with knee problems for over twenty years. Hiking to the vantage point in this photo is something that has caused me much pain for as long as I can remember. This photo was taken last weekend while I stood there, pain free and on an emotional high, which would not have happened without the assistance of my benefits broker. 

Earlier this year I was introduced to some treatment options, made available by modern technology, that have proved to help regrow cartilage. I was skeptical until I heard that the treatments, although quite new, were covered by insurance. I pondered that if health insurance covered it, there must be something to these types of remedies.

Upon further review, I discovered the doctor I chose required a plan that covered out of network providers.  As a result, I contacted my payroll company to inquire about such a plan. After running me around in circles and claiming there was not a plan I could switch to, my accountant advised I reach out to Mike Fidlow at Strategic Employer Planning.  Well, here I am just a few months later feeling like I am back on top of the mountain – mentally, physically and spiritually.

Mike and I worked together as we explored the various plans in the market that offered the availability of out of network coverage.  He explained that carriers offered two types of plans when it comes to reimbursement levels on claims that come form non-participating providers.  This is what is commonly referred to reasonable and customary.  After speaking with the doctor chosen to perform the surgery, we were able to come to an agreement on the plan that worked best for both us. 

Immediately, Mike jumped into action, provided the paperwork to get the submission going to the health carrier, assisted with all questions on the forms, addressed any concerns I had as to what I should expect along the way, and ensured I had my group number and ID’s upon approval.  In fact, he even went as far as making sure I engaged in further conversations with my surgeon to make sure there would be no surprised debt after the procedure was completed – otherwise known as balance billing.

Here is the bottom line for me – I am a 2-person employer group.  My gut tells me that when I reached out for help with my payroll provider I was viewed exactly as such.  When I reached out to Mike, I felt like I was the most important employer on the face of this earth.  My feel-good story starts with the amazing outcome of my surgery and my ability to get back to the things I physically enjoy doing in my life.  And surely ends with the knowledge that there are people out there I can rely on that truly take pride in what they do – regardless of the circumstances.