Phia received a $60K claim caused by a serious fall while the member was hiking. The member was taken to the nearest hospital which was out of network, and where the client had a history of 20% discounts. Phia had previously developed a good relationship with this California Hospital and was able to settle the claim for 13K (200% Medicare). Cost-containment is often claim expertise and legal strength, but relationships always count as well; Phia balances all these considerations in our dealings.
