Patient Advocates for Regence BlueCross BlueShield of Oregon - Find one today.
Supporting and empowering Regence BlueCross BlueShield of Oregon patients.
Regence BlueCross BlueShield of Oregon has deep roots in the Pacific Northwest, but wading through their complex authorization requirements and multi-level appeal process can feel like trekking through the dense Oregon forests without a compass. Your Solace advocate understands Regence's policies inside and out—from securing prior authorizations to challenging denied claims and coordinating specialty care across Oregon's diverse regions. They'll untangle the paperwork thicket, handle the relentless follow-up calls, and cut through the bureaucratic red tape so you can focus on your health instead of battling insurance hurdles.
Best of all, most patients pay nothing out of pocket.
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About
Regence BlueCross BlueShield of Oregon is part of the Regence family of health plans, representing the largest affiliation of health plans in the Pacific Northwest/Mountain region. As a not-for-profit organization with a legacy dating back to the first BlueShield plan in the United States, Regence Oregon serves members across the state with a commitment to transforming healthcare delivery. Their network includes partnerships with thousands of providers and facilities throughout Oregon and neighboring states, providing members with both local and regional access to care. While they emphasize local customer service and community connections, members often encounter challenges with their multi-tiered appeal process, which includes first-level appeals, second-level appeals, and external reviews. Their appeal timelines and procedures can be complicated, typically requiring members to submit appeals within 65 days of receiving a written decision and following specific submission requirements that vary based on the type of service being disputed.
What problems can a Regence BlueCross BlueShield of Oregon 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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Stephen I.
04/27/2024
Jonathan J.
06/05/2024
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07/27/2024
Regence BlueCross BlueShield of Oregon Appeals with a Patient Advocate
Tackling Regence's multi-layered appeal system demands persistence, attention to detail, and specialized knowledge of their internal processes. The system encompasses multiple stages—from initial internal reviews to higher-level appeals and external independent assessments if needed. Your Solace advocate excels at crafting persuasive appeals that speak directly to Regence's review criteria, gathering essential medical documentation, and presenting your case in terms that resonate with their decision-makers. They'll diligently track submission deadlines, ensuring your appeal makes it through the system within the crucial 65-day window from the initial determination.
When confronted with a Regence denial, your advocate quickly dissects the underlying issues—whether stemming from documentation gaps, coding inconsistencies, network restrictions, or disputes about medical necessity. They'll partner with your healthcare providers to assemble compelling evidence supporting your treatment needs and may orchestrate critical discussions between your physicians and Regence's medical review team. For particularly challenging cases requiring an objective third-party perspective, they understand precisely how to elevate your appeal to independent reviewers who can deliver an unbiased assessment. Throughout this complex journey, they maintain transparent communication, translating convoluted insurance terminology into clear, straightforward language so you're never left in the dark.
In Oregon's complex healthcare terrain, from Portland's urban centers to rural coastal and mountain communities, a Solace advocate isn't just convenient—they're your essential ally in the fight for the coverage you deserve.
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.