Michael was diagnosed with lung cancer with brain metastases, a condition where cancer from another part of the body spreads to the brain. If left untreated, he didn’t have very long to live. Luckily, as part of his benefits, Michael had access to SentryHealth’s care navigation program. When his care team found out about his condition, they jumped into action, collaborating and coordinating with his health plan and physicians to get him the very best treatment.
This was a life-changing event and Michael was devastated. He was anxious and needed help making decisions and getting treatment. Not only did he need support navigating his diagnosis, but he was referred to a doctor who wanted him to pay for everything upfront. To compound his emotional stress, he now faced a financial crisis.
Michael’s Registered Nurse Advocate and Certified Case Manager immediately got involved. They first connected with the doctor’s office, but unfortunately, they wouldn’t consider anything other than Michael paying for treatment upfront. Like most Americans, Michael couldn’t afford to do so.
His case manager went to work, identifying several other high-quality doctors in Michael’s network that had open appointments. She also collaborated with Michael’s health plan to guarantee coverage. During this process, she continuously communicated with him to keep his anxiety down and reassure him that he would receive the best care available.
Michael selected a new doctor and is getting excellent treatment without having a huge financial burden hanging over his head. His employer’s benefits advisor shared, “This is exactly what a member experience should be – a case manager holding their hand and walking them through every step, and involving other partners so members get the best care from the best doctors at the best cost.”