Health Navigaid, LLC
Most services: nationwide
Accompanying clients to physician appointments and arranging for second opinions: Greater Philadelphia, Pennsylvania area only.
My primary expertise is in health insurance/health plan related matters and provider billing disputes. We provide these services nationwide.
We also accompany clients to medical appointments (Philadelphia, Pennsylvania area only); arrange for second medical opinions (Philadelphia area only); and research treatment options to help clients make informed treatment decisions.
Health insurance services range from helping clients make informed and reasoned annual health plan 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 price 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 in part 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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(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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Health Navigaid, LLC