Welcome to ClaimDOC.
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. Our team offers to help account for a provider’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
- 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.
REASONS TO EXPLORE A RELATIONSHIP WITH CLAIMDOC
- COMPREHENSIVE. Our claim audits are completed by licensed healthcare professionals. We’re on the lookout for everything – from billing errors to medical appropriateness and egregious pricing.
- FLEXIBLE. Clients have multiple options, each with rate caps:
A) Post-claim auditing and advocacy; B) Pre-claim negotiation, claim auditing and advocacy; C) Claim-specific auditing and advocacy.
- DIRECT. Our expert staff negotiates claims and direct-to-employer agreements to enhance member experience
Client Case Study
Learn how ClaimDOC generated millions in savings for a fast-growing U.S. trucking company.
Fair Payment Solutions for Health Plans