Health Navigaid, LLC
One of our areas of expertise is in Medicare/health insurance/health plan related matters and provider billing disputes. We also research treatment options to help clients make informed treatment decisions. We provide these services nationwide.
More locally (within the Greater Philadelphia area), we accompany clients to medical appointments and arrange for second medical opinions. Our best work often entails ensuring that all pertinent questions are asked/answered appropriately and are understood by our client, if not at during the appointment then soon after.
Health insurance services range from helping clients make informed and reasoned annual health plan or Medicare choices to representing clients in health plan disputes and appeals. Our approach to assessing annual health plan options is unique – we go far beyond superficial comparisons to find the best fits for our clients.
Our client testimonials attest to our extraordinary track record in resolving health plan disputes. This success is attributable in part because we only pursue appeals where we believe there is a reasonable likelihood of winning, in part because we are technically expert at crafting appeals, and also because we fight relentlessly for the well-being of our clients.
If we do not believe an appeal can be won or in the event an appeal is not successful, we are skilled and aggressive negotiators who can communicate directly with your health care providers. In short, if there is a way to improve your situation, we often can get you there.
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Rick was and is an exceptionally knowledgeable captain of the ship that traverses the waters of the always complicated bureaucracy regardless of which bureaucracy it might be. Without him I would have been up the proverbial creek without a paddle. Rick is always available to respond to questions or inquires in easy to understand language at incredibly fair rates. I actually felt that he didn\’t charge sufficiently for a complicated matter that he took to heart and put forth extraordinary time and effort with no details left out. Without going into details of the matter I have only one very sincere thing to say in summary which is that without his expertise and effort I would have been very lost.
My husband and I feel very fortunate to have been referred to Rick Pugach by a dear friend only a few weeks before our daughter and her wife were facing and COBRA plan that didn’t work in the market they’d recently relocated to. Rick was helpful from the first phone call. He thoroughly explained the realities of the market and was clear and concise with explaining options. As parents, we didn’t want to impose on family members in order to assist them. Rick already knew the best path to assist and provided the confidentiality and impartiality we needed. I am grateful for Rick and for the prompt solution he provided for our family! I won’t hesitate to recommend him to others.
I recently found myself in a medical situation and I learned that as I would conference with doctors and try to assimilate what they were saying and to formulate questions I was having difficulty because they were speaking in medical terms that I did not understand. When I had someone with me it was the same situation, we were unable to grasp what the doctors were saying. We went on a google search thinking this just can\’t be me and sure enough there is a class of professionals who deal with these situations in particular. I subsequently settled on Rick Pugach after interviewing several health advocates and I am very happy I did. Rick was with me on doctor visits and I could see from the very beginning he knew the right questions to ask and he discussed the answers with me in depth right in the doctor\’s office so I knew exactly what was transpiring. Not only would he go with me personally, if I was out of the region he would be on the phone for my visits. His personality fits what he has to do for his job. He cuts through the medical jargon, is an amazing advocate for his clients via phone or in person, and he explains everything in laymen\’s terms to myself as well as anyone with me. I would highly recommend him to anyone who was in the position to need a health advocate.
Our family recently incurred a huge bill for an emergency air ambulance transfer. After much back and forth with our medical insurer, they ultimately agreed to cover a large portion of the bill. But they did not pay the entire bill, as the air ambulance provider was out of network. So, we were still left owing a very significant balance to the provider.
At that time, we were very fortunate to come into contact with Rick Pugach of Health Navigaid. Rick is very knowledgeable and has extensive background in the healthcare field, as well as significant experience with medical insurance.
Rick was very forthright in explaining that he would give it his best effort in assisting but could not make any guarantee that we would be able to negotiate down all or even a portion of the balance billing with the air ambulance provider. Air ambulance companies are known for often being very aggressive in collecting outstanding balances.
However, thanks to Rick’s expertise and guidance, we were ultimately able to arrive at a very favorable outcome with the air ambulance provider, with them writing off the entire remaining balance.
Rick was a godsend and a tremendous advocate in this process. He was in constant contact with us as we communicated with the company and negotiated a settlement. We highly recommend Mr. Pugach to anyone who might be facing an issue with a medical insurer or provider.
I’m sure in setting up Medicare I could have stumbled thru the various online guides, both government and commercial — and come up with some choices. But there are enough “black holes” — deceptively simple things with major implications — that I’d have paid dearly for trying. Just one simple checkbox can matter far more than it appears. Rick was the perfect guide thru this obstacle course — he knew already where my confusion would be, and where the pitfalls are. He set out a plan for the project, a reasonable schedule for completing the various milestones, and checked my progress as we went forward. Even joined me on some critical phone calls, a real partner. Empathic. Funny, too. And I sleep better at night knowing I’ve made sound choices. Bravo!
I had an emergency, and was hospitalised while visiting New York last April (2018). I was subsequently presented with the hospital bill, the amount for which was a multiple of what I would expect. Rick was recommended to me as a professional who could assist me in dealing with the hospital. Rick did a wonderful job, guiding me in my delicate negotiation with the billing agent of the hospital. A reasonable settlement was reached. Furthermore, Rick looked out for my interest going forward. I would recommend Rick to anyone who might find himself in a difficult position with a hospital.
I want to give a shout out to Rick Pugach for supporting me with some painful orthopedic issues earlier this year. He explored and then explained insurance coverage, expedited my initial appointment, attended most of my visits, made sure that the necessary questions were asked and answered in a manner that I could understand, and talked me down from the ledge whenever I needed it. I recommend Rick highly to anyone who needs help navigating the health care and health insurance systems. His pleasant yet assertive personality combined with a vast knowledge base of the healthcare system made him a truly formidable advocate for me
(Washington, DC) Rick is a kind, empathetic person, who is ruthless in finding flaws in the medical billing system. We asked Rick to help us sort through months of complicated medical bills. Through his thorough work, he was able to save us thousands of dollars.
(Kansas City) I can’t recommend Rick highly enough! He was professional, compassionate, caring, supportive, listened to my needs, talked me down when I needed it, never let me lose hope, and was all I could have asked for in an advocate.
(Haymarket, VA) I would like to thank Patient Navigator for holding our hand during an arduous journey that lasted more than one year following an emergency cardiac surgery for my father. Rick Pugach was our primary support system in helping to resolve multitude of insurance claim issues, many of which were overly complex on account of being out-of-network. There were so many moving parts he managed: – Oversaw reprocessing and payment of multiple denied physician bills through insurance. – Worked with insurance company to reverse denial of medical necessity for helicopter transport. – Worked with insurance company to reverse denial of medical necessity for extended hospitalization due to hospital-acquired infection. – Prepared and submitted a complaint to the Virginia Bureau of Insurance to help resolve outstanding issues when disagreements could not be resolved any other way. – Last but not least, negotiated settlement with one service provider to (very) substantially reduce balance owed. I highly recommend this service to anyone caught in the complex maze of medical insurance claims.
(Washington, DC) I can’t say enough about how wonderful Rick was as my advocate. When I hired him, I was at the end of my rope with my medical bills. He talked me off a ledge, acted as my confidant, and most of all, was incredibly hard working and diligent when dealing with my case. I’ve never worked with someone who put so much time, effort, and emotion into their work. Thanks to Rick, I escaped paying tens of thousands of dollars in medical bills that I otherwise would have paid. Rick is the best!!!
(Great Falls) A dear friend who’s survived cancer twice referred me to Rick Pugach when I faced the daunting task of finding insurance for myself and my young adult son after a difficult divorce and resulting financial strains. Rick researched our options thoroughly and carefully explained the benefits and pitfalls of each with kindness and empathy. He then spent hours working out snafus for us during the application process, thoughtfully sending us reassuring emails that progress was being made as he unraveled the computer glitch and tie-up. He was a true champion and advocate, and his no-nonsense sincerity and dedication to our needs were such gifts in hard times. He’s a lovely human being as well as a meticulous advisor!
(Bealeton, VA) I was immediately impressed how attentive and responsive Rick was in my situation. He immediately put me at ease and instilled a voice of reason and confidence in me. He was able to resolve my issue in a timely matter and all the while communicated his progress each step of the way to me. I would highly recommend him to anyone who has any of the issues of the services advertised. Thanks Rick!
(North Carolina) I had expensive insurance but that didn’t stop the hospital from sending a large bill eleven months after my surgery. All the doctor, pharmaceutical and consulting bills associated with my surgery were covered. Only the hospital supply bills were denied. I finally did a little research online thinking I needed an attorney. I stumbled upon a website that discussed the use of medical advocates for cases like mine. I found several medical advocates online and decided on Rick Pugach. I emailed Rick late on a Sunday night and he replied within minutes. Rick was a terrific sounding board. He kept me focused and involved throughout the whole process and contacted me regularly as he waded through all of my paperwork. My only regret is that I tried to resolve the problem on my own for so long before contacting Rick. My case is settled and I no longer owe the hospital any money. I am convinced Rick doesn’t sleep. He was available constantly. His sense of humour was a nice bonus!
(Somerset, NJ) Rick grasped quickly the details of my case, and he carefully explained the possibilities to me. He was organized and methodical in his approach. Rick communicated with me frequently and clearly, and he always tried to cheer me up during my down moments. He was relentless in fighting for what he believed I deserved. At the end of the day, Rick was able to negotiate a final settlement of my hospital bill that was far better than I ever thought would be possible. I appreciate all that Rick did for me over the last year. It is very hard to find knowledgeable and dedicated help in health care resolution dispute matters. I will whole heartedly recommend Rick to anyone for the services he is able to provide.
(New York, NY)
In February 2015 we had an emergency medical situation that required paying a five-figure sum up front to the medical provider. We had verbal assurance from our health insurance company that we would be at least partially reimbursed once they received the necessary documents. The medical provider also assured us that they would take care of filing our claim in a timely fashion. Despite all our efforts, we received a letter of denial from our insurance company at the end of 2015. We were ready to give up, but knowing that our situation had been mishandled, we decided to make a last-ditch effort by contacting a professional health advocate. Enter Rick Pugach. He took on our case in February 2016. He couldn’t promise us a positive outcome, but despite the many setbacks and road blocks along the way, he kept trying. Thanks to his unwavering perseverance, we received a check from our insurance company for full reimbursement in June 2017. In Rick’s own words, “this case has broken every rule in the book.” Any layman who needs professional help with battling health insurance companies and medical providers should get in touch with Rick immediately. We highly recommend him.
I came to Rick owing almost $100,000.00 in medical bills after rotator cuff surgery. I had met my max out-of-pocket that year and so United should have paid 100% of my surgery. They denied paying any of it due to a ridiculous (and I do mean ridiculous) series of events. After I hit the brick wall of insurance/doctor “pass the buck” – “take no responsibility”, I turned to Rick. He saved me with his tenacity, long suffering of insurance babbling, and endless letter writing and phone calls. Not only did he get United to pay the doctor bill, he found a loop hole and got the hospital to lower the bill from over $80,000.00 to $1,200.00. I did not make a mistake in typing that number….. It took over a year, and Rick never gave up. We are finally finished and I feel like I have made a friend. If you have insurance issues (even if it looks hopeless), Rick will not quit until your case is settled in your best interest.
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