Senior Living Company Sees $9M in Annualized Savings

A large senior living company with multiple locations in the Northeast experienced significant savings in their first year with ClaimDOC. With more than $9 million dollars in annualized savings, the client saw 35% in savings when switching from their traditional PPO to ClaimDOC’s reference based pricing.

In addition to these savings, Pave the Way®, ClaimDOC’s proactive provider outreach and education program, ensured members were able to see the provider of their choice. Pave the Way® is one of the most differentiating aspects of ClaimDOC’s  reference based pricing plan, and there’s nothing else like it on the market. With ClaimDOC, this client’s members experienced a 94% provider acceptance rate, combined with a post-payment acceptance rate of 98%. In general, Pave the Way® has a high success rate, with an average of 90% provider participation. 

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Pave the Way® begins when a member nominates their provider of choice. From there, a ClaimDOC Member Advocate helps the member navigate the new health plan every step of the way. Once the nomination is submitted, Member Advocates educate the provider about the new plan at least 60 days prior to the appointment and confirm that the provider will submit claims. In the rare occurrence that a provider declines to submit claims, Member Advocates help members find another provider. With this client, ClaimDOC successfully processed 1,514 provider nominations.

“My Member Advocate, Levi, was amazing! I needed help finding a provider. He assisted me in finding four different doctors including a gastroenterologist, primary care provider, rheumatologist, and psychiatrist,” a member said. “Levi is always responsive and never makes me feel disregarded. Having a Member Advocate has helped me understand my medical plan without any stress.”

While the client operates in a region that calls for increased contracting, ClaimDOC balanced plan savings and strategic contracting with member experience to ensure member access. This specialized and thoughtful RBP application makes ClaimDOC the most sustainable cost containment solution.