Power Your Health Plan With DirectAccess+^™

Finding the right partners in the emerging field of reference-based pricing can be difficult. Inexpensive models often come with liability gaps, while pricier vendors bridge gaps yet fail on service expectations. ClaimDOC, a leader in the pursuit of fair payments for self-funded health plans, is setting a new standard. 

Pave the Way®

A proactive provider outreach program, Pave the Way smooths the transition from traditional networks to DirectAccess+. It begins during implementation and continues throughout the duration of the plan. 

 

Claim Auditing and Repricing 

Line-by-line audits are conducted on all facility claims and professional claims over $2,000. Facility claims are repriced to the greater of Medicare plus 25% or cost plus 20% to ensure fair and reasonable payment to healthcare providers. 

See how much clients save with DirectAccess+ → 

Balance Bill and Legal Protection

As a co-fiduciary, ClaimDOC acts in the best interest of the plan and its members. Our legal team handles provider claims, manages legal disputes, and oversees the appeal process in accordance with ERISA and plan document language.

Compliance Tools and Portal

We pair plan access with pricing, using compliance technology. You receive built-in compliance with the No Surprises Act. MRFs are posted, and we produce QPAs and manage independent dispute resolution on behalf of the plan. 

Learn more about ClaimDOC’s new portal →

MedCash™

A point-of-sale payment option, MedCash minimizes friction at the doctor’s office. We negotiates a payment agreement when a provider requests an upfront payment. 

 

Ready To Make the Switch?

Questions? Ready to get going? We’re here to help.