Midyear Business Update — The Best of Times
Sometimes you just have to turn on some classic rock to get your mind right. I’m not sure how much Styx knew or cared about medical benefits, and “The Best of Times” might have been a pseudo love song, but it hits the spot for us at this moment.
Our entire staff focuses on problems and spends each day grinding out the best possible solutions. Our clients and their brokers are also making a choice to do something that’s more complex and requires more work than a network solution. Taking on the challenge of unaffordable healthcare and the systemic pressure to just fall in line is hard, but you have to step back and appreciate what is being accomplished. The current level of intense interest in RBP up against those desperately trying to suppress its adoption has created a unique dynamic, making this such an incredible time to be in the cost containment space. It really is the best of times for ClaimDOC.
The volume is way up on alternative strategies and this midyear update will share what we are seeing in the market and how it impacts the direction of the company.
Sales in 2025 will reach record numbers at ClaimDOC. We are at 70% of our 2024 sales total with the Jan. 1, 2026, sales season still coming. One of the coolest parts about the year we are having is the diversity. Twenty-two different firms have brought a case to ClaimDOC, and 56% of the brokers are putting their first case with us. New clients are spread broadly across different industries, with the hottest industry being car dealerships. The number of third-party administrators these cases are going to has narrowed significantly compared to prior years. A handful of TPAs have become very proficient at administering our solution and appreciate the value our solution delivers. They know what we do isn’t a sales pitch, it’s a commitment and we can be demanding. As they have elevated their ability to provide an exceptional experience for our clients, we’ve grown resistant to working with TPAs incapable of delivering the same results.
Not a lot changed in terms of areas of the country covered in this year’s updated map that reflects where members we support live, but it is much denser. While new clients are mostly in the same markets, Danielle Young has elevated our brand in her markets and Omar Arif has grown our presence in North Texas and Oklahoma. Insignificant to our national market, but meaningful to our roots in Iowa, we have seen more interest than ever here locally. In a shocker, two school districts elected to walk away from the dominant network school option and attack the challenge of balancing their budgets via their most inefficient spend — healthcare. These aren’t revenue game changers for ClaimDOC, but they reinforce that we are in a new world of acceptance, and it feels good to help school districts.
Operations
We continue to surprise people with the sophistication and scale of our operation. We are up to more than 160 employees, with the bulk of those at the home office in West Des Moines, Iowa. The focus each day for the staff is executing network replacement — audits, claims processing, IT, account management, member advocacy, quality assurance, training, balance bill support, provider contracting, sales, marketing and legal. I can’t think of a single area we haven’t upgraded. It’s a constant pressure to offset sales growth with growing internal resources so we always meet our own expectations for quality. This emphasis from CEO Ben Krambeck reinforces to staff this is a mission, not just a business to make money. We don’t always get it perfect, but we work like heck to always hire out ahead of new business.
I want to reiterate something I mentioned last year, and it connects to Ben’s strategy of pushing for internal growth in line with sales growth. Revenue growth isn’t getting a handful of people rich, it’s the fuel that powers our talent acquisition and innovation. While our sales team sees their pay rise as they drive more revenue, nobody else in the company operates with that dynamic.
We will continue to execute a smart growth strategy. This isn’t a sprint for us to add new business or throw money at clients to stay with us like one competitor in the market is now doing. We don’t run our business based on massaging metrics to put on lipstick for investors. If clients want to leave you because your service sucks, you need to fix the problem. I totally understand the strategy. It’s less expensive to pay brokers and to just throw money at clients that speak up than to fix the problem. It lacks pride and brings into question overall operating principles, but to each their own.
Pave the Way® Update
Audit numbers provide insight into smart growth, and our Pave the Way® output gives you a chance to see where the rubber hits the road. The bulk of the clients that have migrated to us from both traditional networks and RBP competitors have done so based on our commitment to driving access without relying on contracts. You’ll see in this chart that we don’t just talk about it, we deliver.
I stated last year that Pave the Way is an intensive and expensive endeavor, which is why there isn’t another competitor willing to reinvest in their member experience the way we do. Some might read that and point to the outreach programs our competitors are coming up with, but the key is investing in the program. We have added 31 new member advocates to the team since December. Ben put the pressure on to increase the pace and hire throughout the year in anticipation of his sales expectations for this year. It’s difficult for me to say these words but, he was right. Our member advocate team averages 374 outbound calls per day. We completed over 21,000 nominations in 2024, and we have done nearly 11,000 in 2025. Anyone who knows the RBP space well knows what we do is on a totally different level. It’s nice to be in the majors while those just recognizing the value are warming up for their Little League game.
Real Estate Purchase
Another year and another conversation on real estate. At the end of last year, we completed the renovation of shell space in our office to add 45 new workspaces. Now, we have purchased a 10,000-square-foot building that sits adjacent to our current property. Like I said last year regarding our renovation, there were cheaper options, but this was the best possible solution. Maintaining the culture that creates a level of service clients aren’t getting from our competitors is critical to us. As always, we welcome anyone to visit our office any time. We are very proud of what we have built and when you walk through the office on any given day, you’ll understand what is different about what we are doing.
Kind of tricky to catch me riding an upbeat wave, but nothing lifts me up more than ClaimDOC employees who carry the heaviest loads understanding the impact they are having. In our office, you see collaboration, smiles and hard work. It’s not utopia, it’s not right for everyone and we can’t be everything to everyone. We try damn hard to be a good employer and our team deserves it. People will sometimes thank me for a raise and I’m like (using their language), “Bro, you earned it, don’t thank me.” This email I received last week hits the nail on the head describing our culture. We have to keep this mindset shared by so many on our team.
“I often find myself reflecting, even after hours, on how I can better serve our clients and improve the way I do things because I just love the work I do. I’m truly blessed being here. Knowing the company recognizes and supports the commitment I make day and night makes being part of this team even more rewarding.”
— Heidi, ClaimDOC Account Manager
Our clients are taking control of their healthcare spend. The members we support are keeping thousands of dollars in their paycheck and bank account that was previously going to higher premiums and deductibles. The brokers shielding this from their clients who need help know it works, and they know they are the problem. It is the best of times at ClaimDOC.