PBD
Healthcare Advocates, LLC
PBD Healthcare Advocates
Claims and Benefit Consultants
PBD Healthcare Advocates' goal is to assist our clients through the healthcare maze. With decades of industry-specific experience, we help them from going around in circles and bring a real-world understanding of the challenges they face.
The Health care system is very complex and often not patient or consumer-friendly. We are the interface that can translate. We’re recognized as advocates, and professionals who understand the ins and outs of health insurance because we speak the language and provide timely insurance solutions.
Our employees are devoted to serving our customers and knowing insurance.
Working effectively with our clients building solid relationships and retaining business. The Claims and Benefit Advocates works with our Clients, Carriers, and Vendors. The service timeline focus is on Claims and Benefits Reviews. We provide services for our clients via in-person and Teams meetings. Our services include claims processing expertise, benefits auditing, customer service, document storage, and other administrative servicing as advocates on client claim issues. We work independently with clients, consulting on items that have a significant impact on claims denials. We serve as Claims and Benefits Advocates with great knowledge of complex claims. We will:
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Respond to claims issues/disputes as needed.
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Hold conference calls with insurance adjusters/supervisors to discuss claim concerns.
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Provide regular claim status reports to our clients.
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Assist with special projects as directed by the Claim Manager and/or Director of Claims.
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Attend selected seminars and other development opportunities.
Why Choose Us?
We are committed to providing high-quality services.
We aim to help you receive the benefits you’re paying for.
We have a team of highly skilled and qualified professionals
We have extensive experience in the industry.
We always strive to meet the expectations of our clients.
About Us
YOUR EXPERIENCED HEALTHCARE ADVOCATES
Our Mission
PBD Healthcare Advocates, LLC supports our customers in “navigating the healthcare system.” We advocate for you to get your claims paid and help you to understand your benefits.
Our goal is to ensure that your claims are paid correctly. When people call with a problem they get the help they need. We are proactive rather than reactive. Our services consist of performing audits, holding classes, and giving lectures. We interface with your insurance company and contact them for you. We review your denied claims to confirm the accuracy and assist with filing an appeal. We will let you know what to expect before you get sick. Explain your In-Network and Out of Network benefits. Limits, and non-covered services. Make sure your healthcare benefits are correct for claims processing and ensure our clients receive accurate services. Making sure they get what they are paying for.
Our Story
Established in 2020, PBD Healthcare Advocates, LLC started as a small, minority-owned business post-employment with the World Trade Center Health Benefit Program, Blue Cross Blue Shield of Georgia, Kaiser Permanente, and Administrative Services-TPA. The founder has more than 30 years of medical claims processing, auditing, and healthcare call center-customer service and management consulting experience.
PBD Healthcare Advocates, LLC was contracted and supported the CDC in 2017 as the Claims Subject Matter Expert for the World Trade Center Health Program and functioned as the “Senior Claims Analyst.”
HEALTHCARE ADVOCATES, LLC
The primary duties were to focus on claims research as well as provide claims guidance on complicated and/or high-cost claims, denials, refunds, appeals, and recoupments to the WTC Health Program’s Quality Assurance Officer.
Provided support to the quality assurance officer and assisted the medical and pharmacy team in resolving pending claim issues. Secondary duties included providing technical assistance to the WTCHP Health Program Support (HPS) contractor to adjudicate claims and maintaining the WTC-related certified health conditions database and WTC-3s on behalf of the WTCHP, which is housed within the CDC’s National Institute for Occupational Safety and Health. This program provides limited healthcare benefits to the first responders and survivors of the 9/11 attacks.
Today, PBD Healthcare Advocates, LLC continues to advocate for individuals who were impacted by the 9/11 attacks, assist individuals in navigating their health plans, and perform auditing and claims processing services.
Our experienced team offers expertise in healthcare administration, claims processing and health benefits auditing, coding, case management, and call center customer services.
Choose PBD Healthcare Advocates, LLC
If you’re looking for medical claims service professionals who you can depend on, choose none other than PBD Healthcare Advocates, LLC. Our team of experts is dedicated to providing you with dependable medical claims processing and support services. If you wish to learn more, please do not hesitate to give us a call or send us an email. We look forward to hearing from you soon!
EXPERIENCED HEALTHCARE ADVOCATES
CONTACT OUR ADVOCATES TODAY
As your trusted medical Healthcare Advocates, our aim is to provide high-quality services to our valued clients. Our claims processing and benefit audit experts go above and beyond to cater to each project’s specific needs. Through open communication and exceptional service, we hope you’ll find what you’re looking for with our small claims assistance service.
For more information, please contact our medical claims processing and auditing business by phone or email. We’re more than happy to discuss with you how you can benefit from our expert services.