Keeping Claims Honest – The Role of a Fiduciary
ClaimTalk Ep. 5 As a fiduciary, you are responsible for ensuring medical claims are billed accurately. If your plan administrator is…
Resources
Excessive Markup of CT Scans — What Is a Fair Charge?
Background ClaimDOC’s comprehensive line-by-line review of claims uncovers errors that basic claim repricing and auto-adjudication do not catch, leading to greater savings for medical plans…
Midyear Business Update
Around 2019, a broker in Georgia told us he wasn’t interested in telling anyone about how well we’d performed for his clients because he didn’t…
Audit of Chemotherapy Bill Saves Member $12,676.26
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…
RBP From the Front Lines: How Do You Measure Great Member Experience? With Baby Pictures
ClaimTalk Ep. 4 How do you silence RBP noise? In this month’s episode of ClaimTalk, we interview rock star member advocate…
Red Flags — Egregious Anesthesia Charges Billed to Member
Background In this Claims Audit Spotlight, we focus on recent claims where a ClaimDOC auditor raised red flags and asked the same question on both…
Member Saves $3,817.09 After Surgery Bill Audit
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…
Medical Debt & Credit Impairment — Fear Tactics Taking a Hit
In case you missed it, the Biden administration recently announced that the Consumer Financial Protection Bureau would work toward removing medical…
Winning the RBP Access War, With or Without Contracts
ClaimTalk Ep. 3 Direct contracts are very different from direct access. In our latest episode of ClaimTalk —Winning the RBP Access War, With or…