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In this episode of Care Beyond Code, we're joined by Alberta Manga and Miranda Buder from Custom Design Benefits. They discuss how their unique in-house medical management and patient advocacy teams use data to predict and prevent high-risk hospital admissions.
Listen as they share two high-impact stories of real people navigating difficult diagnoses. Learn how Custom Design Benefits secured a single case agreement for out-of-network cancer care in just three hours to avoid surprise billing. Then, hear how they guided a patient through post-discharge financial anxiety by securing community resources and setting up a hospital payment plan.
What you will learn:
-- How in-house case management eliminates lagging data transfers to assist members immediately.
-- Why looking at the social determinants of health is crucial for a successful patient recovery.
-- How three-way calls can help laymen navigate complex hospital financial conversations.
00:00 Welcome to Care Beyond Code
00:46 Introduction to Custom Design Benefits
01:45 The Advantage of In-House Medical Management
03:21 Predicting and Preventing Future Health Crises
05:04 Addressing Social Determinants of Health
06:44 Story 1: A Testicular Cancer Diagnosis
08:28 Securing an Out-of-Network Single Case Agreement
11:15 Resolving Patient Frustration in Just Three Hours
15:04 Building Long-Term Trust with Patients
16:25 Story 2: Recovering from a Ruptured Appendix
17:27 Providing Community Resources for Financial Anxiety
20:44 Navigating Hospital Payment Plans via Three-Way Calls
22:24 The Importance of Compassionate Healthcare
Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com. Don't forget to subscribe for more insights into the future of healthcare tech.
