Welcome to ClaimDOC.
About Us
Fair payments for self-funded health plans. ClaimDOC provides claim review and auditing services) to self-funded health plans. Our team of experts helps employers and their brokers realize the benefits of these alternative health insurance plans faster and in a more meaningful way.
ClaimDOC’s proven audit program relies on objective industry data that empowers our licensed healthcare professionals to negotiate fair, ethical and effective payments. Offers into account aprovider’s actual cost, as well as a fair margin, to ensure mutually beneficial outcomes.
Our employee communication and internal marketing campaigns make life easier for the HR professionals of our employer clients. Podcasts, printed materials, even boots on the ground, help members see clearly the tangible value of self-funded health plans.
ClaimDOC is a co-fiduciary, advocating for patients & their employers
ClaimDOC provides:
- Claim Auditing ERISA Appeal Management
- Member Advocacy
- Legal Defense for Litigation
- Balance Bill Defense
ClaimDOC's audit program
prioritizes employee trust and advocacy to ensure a self-funded health plan’s long-term success.
Our Payment Process:
Efficient Turnaround On Payments To Providers.
Our Appeal/Balance Bill Process:
ClaimDOC is a Co-Fiduciary to Self-Funded Health Plans.
CASE STUDY
The Importance of Auditing for Billing Errors
Introduction
ClaimDOC maintains its clients’ rights to audit medical bills for Medicare conformance and billing errors.
Summary
- The member was treated for chronic cholecystitis at a hospital facility in central California.
- ClaimDOC auditors identified a billing error caused by unbundling of certain charges.
- ClaimDOC reduced the bill even further per its audit process in accordance with the member’s plan.
Outcome
- Provider’s Billed Charges: $56,849.64
- Total Amount Saved: $50,944.34
Contact Us.
Fair Payment Solutions for Health Plans