Case Study: The Second Opinion That’s Saving Lives

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THE CHALLENGE: “Mark Lamb ought to be dead.” That was the opening sentence in the 2022 “White Mountain Independent” article on Mark’s life-threatening health scare and the string of despairing roadblocks he encountered in his search for help. An equipment operator with the Navajo County Public Works Department in Arizona, Mark was diagnosed with cancer in the fall of 2020 and was told his illness was too advanced to respond to chemotherapy or radiation. Mark sought a second opinion – and received even worst news: a prognosis that he had just months to live. Determined to keep fighting, Mark turned to a nationally recognized name in healthcare but was told it could not accept his insurance. It seemed as if his options had run out.

OUR SOLUTION: Because Navajo County was our client, Mark was able to turn to a feature in his benefits plan that many, if not most, employer health plans do not have: the concierge care and support services available through Edison Healthcare. The team at Edison helps patients with serious and complicated medical conditions find the expertise and resources they need, often at no cost and with travel and accommodation costs covered, too. Edison believes that medical issues are often misdiagnosed and, as a result, patients receive improper or unneeded treatment. Edison caseworkers reviewed Mark’s records and made an appointment for him at a clinic in Beverly Hills, Calif.

THE OUTCOME: Mark was flown out to California and received six weeks of radiation therapy. The doctors also discovered he had a potentially fatal heart blockage. That was treated at a hospital in Oklahoma, again thanks to an assist from the team at Edison. While the kind of attention and help Mark received sounds expensive, Navajo County is saving about $350,000 a year on the health care plan that we designed for it. Better still, the last time we checked, Mark was back at work.

The Mahoney Group, based in Mesa, Ariz., is one of the largest independent insurance and employee benefits brokerages in the U.S. An employee-owned organization, we’ve been providing our clients with the Confidence to Face Whatever Lies Ahead for more than 100 years. For more information, contact us online or call 877-440-3304.

This article is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice.

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