Lives impacted for the better in September 2024

I Chandan Kumar, her CareBuddy received a call from the patient who exclaimed that she was in severe pain and needed immediate dental treatment. She had already been suffering for several days, and her condition was worsening. Her family doctor had started treating her, but financial complications were causing delays in getting the necessary care.

The patient was desperate. The removal of her dental pulp left her unable to eat, and the liquid diet she had been on for days wasn’t helping her mental or physical health. She didn’t have six or seven teeth, and the pain was unbearable. Her family doctor suggested a complex treatment that involved a dental crown and implantation, a procedure that would cost between 1.5 to 2 lakhs – an amount she couldn’t afford

I, her Carebuddy - Chandan Kumar immediately understood the urgency and reassured her, explaining that I would take care of everything. She told me that she wanted to use her corporate insurance benefits, but there was a problem – a glitch in the database. The promised coverage was supposed to be around 90%, but the system only showed 30-40%. Time was running out, and the patient couldn’t afford to wait for a slow resolution.

I first liaised with the Account Management team, the insurance provider, and the IT department to identify the root cause of the discrepancy. There was an issue with the eligibility displayed on the database, something that required backend configuration changes. The approvals from multiple departments became a crucial part of the process. Despite this, I consoled the patient, keeping her updated every step of the way.

The patient offered to pay upfront and claim the amount later, but since there was no certainty of reimbursement, I knew that wasn’t a good option. Cashless coverage was the best solution, but it couldn’t be applied to the full amount due to the glitch. After multiple discussions, I managed to get approval for an exceptional reimbursement case, which would allow her to proceed with the treatment.The patient, though in pain, expressed her gratitude for pushing so hard to find a solution. However, the process wasn’t over yet. The next step involved coordinating between the hospital, the TPA (Third-Party Administrator), and the patient’s family doctor. I made sure the patient knew that she could proceed with her treatment without financial worries. With approvals in place, the funds would be transferred to her family doctor directly.

The treatment began, and I stayed in constant contact with the patient and understood the emotional toll this ordeal had taken on her. While her physical pain was immense, the stress of dealing with insurance complications made it even worse. Still my consistent support helped her stay calm through the ordeal.

Eventually, the dental crowns were placed, and the patient could finally eat solid food again. Her health improved, both physically and mentally. I continued to monitor her progress until he was certain she was fully recovered.

At the end of the process, the patient expressed her deep gratitude. Despite all the challenges, my dedication as her Carebuddy had ensured her treatment was completed, and her financial burden was eased. I, her Carebuddy, liaised with multiple teams – from IT to account management to hospital staff – and made sure the patient got the care she needed.

The entire Medibuddy team, including the Carebuddy, Clinical Coordinators, and Insurance Team, worked diligently to ensure that all procedures were completed successfully. The relief and joy on his face was evident when she was discharged. Her family, who had been equally stressed, couldn't believe their good fortune. They expressed their heartfelt gratitude, overwhelmed with happiness.

And so, her story serves as a testament to the power of medical expertise and care, enabling her to embrace life's joys once again. She and her entire family were extremely happy with the entire MediBuddy team being so supportive who took complete Ownership. The patient quoted – ‘I take this opportunity to appreciate the creative work started by MediBuddy for people all across India and it is excellent that High Quality Healthcare is being made accessible to all.’