Claim Denials: Their Rippling Effect on Health Plans
Claim denials are a complex piece of the healthcare system, and they can cause frustration for patients and providers alike. There are many…
Resources
Exorbitant Charges Billed by Surgeon and Assistant Surgeon for Spine Surgery
In the U.S., back pain is one of the most common reasons people seek medical care and treatment. There are multiple treatment options for back…
Navigating NSA Nightmares
Navigating the No Surprises Act often feels like a perilous fight for insurers/payors. While it may be unfair to call the system rigged, the independent…
Balance Bill Protection: Often Promised, Rarely Executed
A strong balance bill defense is essential to a successful reference-based pricing health plan. But what does that look like?…
Audit of Cesarean Delivery Saves Member $9,978.12
With DirectAccess+, clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and…
Why Are There Extreme Differences in the Cost for the Same Procedure?
Hospital charges and hospital costs for the exact same procedure can vary greatly. For the purposes of this article, we compare a…
Unlocking Healthcare Savings With Reference-Based Pricing
ClaimDOC Senior Vice President of Growth Omar Arif joined Lester J. Morales on an episode of the Impact Health Care Podcast to share how ClaimDOC…
Audit of 8-Day Hospital Stay Saves Member $10,449.32
With DirectAccess+, clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and…
PBMs: Are You Getting Good Advice – Part 2
In the second half of our discussion on PBMs, Marc A. Sweeney, Pharm.D., BCMAS, Trevor Daer and Mike Kroupa return to give…