She can’t undo the insurance mess, but Shuli Berger makes sure the system works for you

While there are dozens of organizations to help families struggling with health concerns, what happens when you have to navigate the health insurance maze should a crisis hit? That’s when you reach out to Mrs. Shuli Berger, a proactive liaison between insurance companies and health-care providers. And while she doesn’t have one neat solution to the mess insurance has become, she can help make sure the system works for you

The doctor’s face was grave.

“Neuroblastoma is a terribly aggressive form of cancer,” he told the terrified young parents. “You must transfer your baby to a specialized hospital as soon as possible. The care he needs is not available here in New Jersey.” He recommended a well-known out-of-state children’s hospital. “Our case manager will work on getting approval for the transfer.”

A while later, a hospital social worker approached the tiny patient’s bedside. “I’m so sorry,” she said. “The specialized hospital is refusing to accept your child without an authorization, and your insurance company is denying it.”

The parents turned back to the doctor. Could they keep their child in his care until the approval came through? “No, we need to move him out as soon as possible. It’s a question of hours and minutes,” he asserted, explaining that neuroblastoma is a tumor that affects juvenile nervous systems. It can spread quickly, and delaying higher-level care for even one day can have a serious negative impact on the prognosis.

The parents frantically called Chai Lifeline. “What are we supposed to do?” they asked, and the response was immediate, one that is becoming increasingly common in situations of insurance-related medical crises.

“Let’s call Shuli Berger.”

Step Up to the Plate

The frum community is flush with organizations to help families struggling with health concerns. Hatzolah responds to medical emergencies, Refuah Helpline and ECHO advise on the best medical treatment, Bikur Cholim cares for the sick and their families, Chai Lifeline, Mesameach, RCCS, and so many others provide critical support, Renewal works on transplants, heimish pediatricians and doctors will leap into action at 2 a.m. when called, and there are even free rides to and from the hospitals.

But what do you do when a crisis of a different sort threatens health, or even life? Where do you turn when a paperwork issue or insurance restriction blocks a lifesaving medical transfer or treatment?

One person who has stepped into this void is Mrs. Shuli Berger, a liaison between insurance companies and providers, a unique position that has enabled her to solve problems that seem insurmountable. For Mrs. Berger, with her wide net of contacts, it can sometimes be as easy as a phone call to the right person.

If you’ve never needed Shuli Berger and how she can be of assistance, consider yourself lucky. Her personal cell phone rings an average of 30 times daily, with frustrated, desperate, or panicked parents or patients on the line, asking for help when some bureaucratic or corporate hiccup is blocking the care they so critically need.