Patient Advocates for Highmark Blue Cross Blue Shield Delaware - Find one today.
Supporting and empowering Highmark Blue Cross Blue Shield Delaware patients.
Highmark Blue Cross Blue Shield Delaware offers comprehensive coverage options, but navigating their authorization requirements and multi-tiered appeal process can be challenging, especially in Delaware's small but diverse healthcare landscape. Your Solace advocate understands Highmark Delaware's policies inside and out—from securing prior authorizations to appealing denied claims and coordinating care between specialists. They'll handle the paperwork, follow-ups, and persistent phone calls so you can focus on your health instead of fighting with insurance bureaucracy.
Best of all, most patients pay nothing out of pocket.
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About
Highmark BCBSD Inc., doing business as Highmark Blue Cross Blue Shield Delaware, is an independent licensee of the Blue Cross Blue Shield Association serving Delaware residents. Highmark offers a range of coverage options including individual and family plans, employer group plans, Medicare Advantage, and Medicaid through Highmark Health Options Delaware. While they provide access to a substantial network of providers throughout Delaware, members often face challenges with their strict documentation requirements for prior authorizations and a complex appeal process that follows Delaware Insurance Regulation 1310 for timely claims processing. Their system operates with specific timeframes for processing "clean claims" versus those requiring investigation, creating additional hurdles for members seeking resolution for denied claims or delayed authorizations. For Medicaid members enrolled in Highmark Health Options, the appeal process follows additional state-specific guidelines that add another layer of complexity.
What problems can a Highmark Blue Cross Blue Shield Delaware patient advocate help you with?
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Get the clarity you need to make sense of your care and take charge of your health.
We’ll make the calls (and the callbacks) so you can spend more time doing what you love.
Keep your care affordable with lower medical bills and access to local financial help.
Advocates review coverage, handle preauthorizations, and even help with appeals.
Stay on top of the cutting-edge treatment options and leave no stone unturned.
Advocates coordinate your care team so your health never falls through the cracks.
Get the tools and answers you need to make informed decisions about your care.
Advocates help you overcome your healthcare hurdles—no matter how big they might be.
Solace has helped over 14,000 patients and families
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04/01/2024
Eric H.
08/07/2024
Joan H.
05/01/2024
Stephen I.
04/27/2024
Jonathan J.
06/05/2024
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07/27/2024
Highmark Blue Cross Blue Shield Delaware Appeals with a Patient Advocate
Highmark Delaware's appeal process involves multiple stages that can be difficult to navigate alone. For standard appeals, you typically have 180 days from the date of denial to file, and your Solace advocate knows how to prepare comprehensive appeals that include all necessary documentation, proper coding references, and address Highmark's specific coverage criteria. They'll track deadlines, follow up persistently, and guide you through each stage from internal review to external review if necessary.
When facing a Highmark Delaware denial, your advocate will immediately identify whether the issue stems from missing documentation, coding errors, network limitations, or medical necessity determinations. They'll work with your healthcare providers to gather supporting evidence and may coordinate peer-to-peer reviews between your doctor and Highmark's medical directors. For Medicaid members enrolled in Highmark Health Options, they understand the specific appeal process including the right to continue receiving services during an appeal and the option to request a State Fair Hearing after exhausting Highmark's internal appeal process. For Medicare Advantage members, they know how to navigate the unique requirements for expedited reviews when your health requires a quick response.
Delaware's compact size doesn't make navigating Highmark's complex policies any easier—which is exactly where a Solace advocate's expertise proves invaluable.
The Solace care team model
With Solace, you get both a patient advocate and a supporting physician, which we refer to as your “care team”.
Your advocate will be there to manage the day to day aspects of your care: coordinating with doctors, researching potential solutions and communicating updates to you.
Your supporting physician can unlock resources for you and your advocate that might otherwise be out of reach.
We’ve Got Answers
Still unsure how an advocate can help? Explore these answers to the questions we’re asked the most.
How are Solace advocates qualified to help?
Advocates on Solace are experienced physicians, nurses, pharmacists, and other healthcare professionals from a wide range of backgrounds. 98% of Solace patients report better healthcare outcomes after working with an advocate.
What else can a Solace advocate help me with?
What can a Solace advocate not do?
We know our advocates sound like miracle workers, but they have limits. They can’t prescribe medications or diagnose an illness, for instance. They can’t replace your doctor, but they can break down the barriers standing between you and the quality care you deserve.