Why ClaimDOC?

Controlling Costs And Putting Money Back In Your Pocket

Your employer has partnered with ClaimDOC to provide a health plan with greater cost control and transparency. Your employer has made this decision with you in mind. Workers across the country are suffering from reduced benefits with increased costs. This program can lead to reduced premiums and out-of-pocket expenses.

ClaimDOC audits medical claims and ensures providers are reimbursed at a fair and reasonable rate. Your employer could have selected a discount model for auditing, however, they selected ClaimDOC due to our most valued service—extraordinary member advocacy. We’re here to help you navigate this complex healthcare system and help create a great experience.

How Your Plan Works

Your employer’s self-funded health plan has put you in the driver’s seat when it comes to managing your healthcare. You’ll love the freedom to choose your providers without the limitations of a network.

At ClaimDOC, we’re here to support you every step of the way, making sure you get the care you need from the providers you choose.

Pave the Way™

Since your plan is open-access and not associated with a traditional insurance carrier, some physicians or facilities will not be familiar with your health plan. Just tell us who your healthcare providers are, and our Member Advocates will reach out to them, making sure they're set up to submit claims for your care.

At Your Appointment

When it's time to see the doctor, be sure you take your medical plan ID card. You'll be responsible for any copay during your visit. If the medical staff isn't familiar with your health plan, just have them give us a call.

Life of a Claim

Following the appointment, your healthcare provider submits a medical claim to your plan administrator. We'll review the claim, make sure it's accurate, and determine a fair reimbursement rate for the care you received.

Check Your Mail

After your medical claim is processed, you will receive an explanation of benefits (EOB). This is not a bill, but a statement that lists details of the services your healthcare team provided and how your medical benefits were applied. Be sure to pay close attention to the "Patient Responsibility" section of the EOB as this will indicate what you owe the provider. If you receive a bill with an amount greater than what is indicated in the "Patient Responsibility" box on your EOB, give us a call so we can review.

Provider Nomination Form

Want to make sure we're working with your healthcare provider? Send us their contact information and a ClaimDoc Member Advocate will contact them to make sure everything's set for your next visit.

Submit a provider