Executive Summary
While bravely battling a rare form
of cancer, Gale asked Bedsiide to
partner with her during the journey.
Bedsiide provided both clinical and
financial oversight and steering, which
allowed her to find the right providers
and treatments. The Bedsiide Team
provided personalized health
management, daily care coordination,
and claims monitoring services.
The results: Gale survived a rare
cancer, saved her employer
$150,000, and saved her family
over $35,000 in medical costs.
Client Introduction
In 2015, Gale was diagnosed with
Hepatosplenic Peripheral T Cell
Lymphoma – a rare form of cancer
that attacked her bone marrow, liver
and spleen. At the time, Gale
was in her mid-40s, living in
Florida. After two unsuccessful
rounds of chemotherapy, Gale’s
health continued to decline,
leaving her weak and exhausted.
Uncertain about where to go for
treatment or what to do next,
a mutual friend suggested she
contact Bedsiide.
“There is no value that can be placed on the service of Bedsiide, when my insurance was getting in our way, they helped us get it straight, and they have saved me thousands of dollars.”
Challenges
Dealing with the shock of a rare cancer diagnosis, Gale and her family had a lot of questions: Who are the best doctors for treating
this rare form of cancer? Which hospitals should we consider? What costs are involved and will insurance cover treatment?
Onpulse Plan Of Action & Outcomes
Clinical & Personal Solutions
Bedsiide helped Gale find the answers she needed and our team quickly became the first point of contact for
her family and providers.
Gale was considering four leading hospitals, located in Baltimore, Philadelphia, and New York, for her care. Bedsiide
initiated conversations with treating providers at those facilities and reviewed Gale’s medical records with them. With
guidance from our clinical team, Gale selected two top hospitals in New York – Cornell and Columbia. Bedsiide managed
Gale’s care coordination, sourced and involved the right experts, and co-managed treatment between the two hospitals.
Gaining access to these medical experts and facilities is very difficult. And Gale’s type of cancer was so rare, only
100 cases per year are diagnosed in the US, and typically only 1 to 3 cases are treated per year at Columbia. Bedsiide
secured an appointment for Gale with Dr. Ahmed Sawas at Columbia for lymphoid malignancies. He presented Gale’s
case at a symposium and gathered collective options on treatment. A protocol was established, her test results slightly
improved, and the direction of her treatment changed, allowing her entry into two drug trials for blood cancers
After leaving the hospital, Gale began weekly treatment at an outpatient infusion center for 4 weeks. Because her
treatments were occurring in New York City, but her home was in Florida, housing for Gale and her family became
a concern. Bedsiide was able to secure housing in New York through the Hope Lodge, an American Cancer Society
facility for patients who live far from home during their treatments. Her family described this housing arrangement
as “blessing” and their “home away from home” for several months until Gale entered remission.
“Bedsiide is an ideal quarterback for my patients. They are a welcomed asset to the care I provide.”
Financial Solutions
Bedsiide also assisted with the financial aspects of Gale’s care. Our team created an affordable treatment plan
and connected her with both hospital and insurance case managers. Bedsiide helped the hospital case managers
navigate the insurance pre-authorizations, pre-approvals, and denials processes
Gale has health insurance, but the numerous co-payments for her hospital visits, procedures, and drugs over the
course of her year-and-a-half long treatment created a financial burden for her family. “We’re just going to take it a
day at a time to pay what we can, when we can,” she said.
Gale’s bills mounted in part because of a $6,000 deductible on one insurance plan. She also had high out-ofnetwork charges for doctors on a new insurance plan she was put on during her treatment. The prep work for a
bone marrow transplant at one hospital, for example, resulted in a $30,000 bill for her, even though another hospital
ultimately ended up doing the procedure. Throughout her treatment, it wasn’t unusual to receive a $3,000 bill – after
insurance – for lab work or a consultation. “You get bills from the cancer center and then you get separate bills for
the physicians and then you have a copay every time you go,” Gale said.
Bedsiide spent over 40 hours managing Gale’s medical bills and filing appeals with her insurance. During treatment,
Gale experienced a change in insurance companies, which resulted in her claims being denied. Bedsiide identified
that the insurance claims weren’t being processed accurately. An Bedsiide Billing Assistant completed a form on
Gale’s behalf, asking the insurance company to reprocess all of the claims, which they did. Our team successfully
negotiated in-network rates for out-of-network charges, eliminating two out-of-network payments. The result was a
savings of $150,000 from her employer’s insurance bill and a savings of $30,000 for Gale’s family.
According to Gale, “There is no value that can be placed on the service of Bedsiide, when my insurance was getting
in our way, they helped us get it straight, and they have saved me thousands of dollars.”
Final Thoughts
Bedsiide is honored to have served Gale, her family, and her doctors during this difficult season of her life. We
celebrate her remission and wish her many enjoyable years ahead
