ClaimDOC

ClaimDOC is driven to help employers deliver successful and sustainable medical plans for their employees through DirectAccess+™ — ClaimDOC’s unique RBP model.

[ClaimDOC @ClaimDOC_RBP]

As we head into these hot summer months, we’re excited to celebrate this group that brings the heat every day. We’re proud to have them on the team!

#ClaimDOCculture #Anniversaries

[ClaimDOC @ClaimDOC_RBP]

We closed out the month of May with a little mini-golf competition and, in true ClaimDOC fashion, the winner couldn’t be decided without a tiebreaker. After plenty of laughs and a few clutch shots, we officially crowned our top teams.

1st place: Alexis Velez, Fallon Heater, Ryan Beckett and Robin Saxon
2nd place: Donna Edge, Katie Heggen and Tristen Cummings.

Thanks to everyone who joined in and made it a fun one.

#ClaimDOCculture #PuttPutt #MiniGolf

[ClaimDOC @ClaimDOC_RBP]

The relationship between healthcare providers and payers has gotten so incredibly complicated. But how did we get here?

In the latest episode of ClaimTalk, our in-house experts Ben Krambeck, Brad Hansen and Cynthia Swanson join Danielle Young to explore how legislation, regulatory decisions and industry dynamics shaped the current state of the health insurance industry. Going back to the early '80s, they discuss how technological advancements, coding requirements, physician group ownership structures and misguided quality assessments played a role in driving up costs for the working American.

Their conversation takes a closer look at the history behind the system — and why understanding that history can help everybody make smarter decisions moving forward.

https://t.co/0FWlH5u1OH

#ClaimTalk #HealthBenefits #MedicalBilling #PricingTransparency

[ClaimDOC @ClaimDOC_RBP]

Freestanding emergency departments are showing up more often in claims — at a significant cost to health plans. In her latest Audit Spotlight, Cynthia Swanson shares how our audit team identified excessive physician and facility charges at an FSED and helped the plan avoid more than $74,000 in unnecessary healthcare spend.

Read her article: https://t.co/r178hXcT7P

#WhyClaimDOC #ClaimAuditing #MedicalBilling

[ClaimDOC @ClaimDOC_RBP]

Thank you to everyone who joined ClaimDOC at Carb Day at the Indianapolis Motor Speedway last weekend! It was a great opportunity to connect in the Arrow McLaren suite over food, drinks and conversation, with an incredible view of all the action on the track.

The day included pit and garage access, tours, the Wienie 500, and a concert featuring Counting Crows and Switchfoot — making for a memorable experience on and off the speedway.

[ClaimDOC @ClaimDOC_RBP]

Today, we honor the brave men and women who have given their lives for this country. Their sacrifice will never be forgotten.

#MemorialDay

[ClaimDOC @ClaimDOC_RBP]

How the heck did the healthcare industry get here?

Our industry experts — Ben Krambeck, Brad Hansen and Cynthia Swanson — join Danielle Young on the next ClaimTalk to take us back to simpler times, pre-Affordable Care Act, and through all the changes that bring us to today. They deconstruct the complexities of claim reimbursement, coding and billing; explain why they’re hard to navigate; and detail the challenges they pose for brokers, employers and members alike.

#ClaimTalk #HealthBenefits #MedicalBilling #PricingTransparency

[ClaimDOC @ClaimDOC_RBP]

A Florida public school district just reaffirmed how reference-based pricing helps plan sponsors regain control of healthcare costs.

Flagler Schools was facing a 22% renewal hike this year, while its insurance fund was already $800,000 in the red. The district couldn’t sustain another increase.

So, Flagler reimagined its health plan with help from their broker and ClaimDOC. The district joins several other public entities nationwide that have moved away from their traditional plans. The result: the district will offer teachers and staff a plan with no increase in employee contributions while reducing the cost of dependent child coverage by 56%.

As one school board member put it, “Health care as we know it is broken, but here’s cause for celebration. You'd be hard pressed to find any other organization in this environment not drastically increasing their cost of premiums.”

Read more about the board’s decision here: https://t.co/OKt3ViTjbt

[ClaimDOC @ClaimDOC_RBP]

It's not uncommon for providers to have questions about reference-based pricing plans. That’s why strong member advocacy matters.

When one provider required a member to pay $200 upfront and refused to contact us, she ended up overpaying by $162. With Bridget's help, that member secured a full refund.

By preventing unnecessary costs, we help protect both the member experience and the value of the health plan. While $162 may seem small in the context of overall healthcare spend, our member advocates know every dollar matters.

#WhyClaimDOC #MemberCentric #RBP

[ClaimDOC @ClaimDOC_RBP]

Today, we’re celebrating AAPI Heritage Month with a catered lunch from Teriyaki Madness! It’s a small but meaningful way to recognize and appreciate the rich cultures, contributions and perspectives of Asian American and Pacific Islander communities.

As a company that values diversity, we’re grateful for any chance to celebrate the people and traditions that help shape our communities and our workplace.

#ClaimDOCculture

[ClaimDOC @ClaimDOC_RBP]

Today, we’re proud to recognize the outstanding nurses at ClaimDOC on National Nurses Day. Their clinical expertise brings valuable insight to the claims process and helps deliver better outcomes for members and clients every day.

To the nurses who represent ClaimDOC so well, thank you. Your professionalism, compassion and leadership strengthen our mission and the value we bring to our partners.

#WhyClaimDOC #ClaimAuditing #NursesDay

[ClaimDOC @ClaimDOC_RBP]

To all the talented individuals who came to the DOC side in May, happy anniversary, and May the 4th be with you!

#ClaimDOCculture #Anniversaries

[ClaimDOC @ClaimDOC_RBP]

If responsiveness were on the ballot, Riley would win in a landslide.
We’re just grateful she’s advocating for our health plan members.

#WhyClaimDOC #MemberCentric #RBP

[ClaimDOC @ClaimDOC_RBP]

Claims get overpaid.
What matters is whether anyone catches it.

After treatment for coronary stent stenosis, ClaimDOC audits recovered nearly $31K for the plan and $9K+ for the member — from one claim.

That’s real oversight.

See more savings examples at:
https://t.co/YtzXHReBhv

#WhyClaimDOC #DirectAccessPlus #ClaimAuditing #RBP

[ClaimDOC @ClaimDOC_RBP]

There’s been a definite shift recently. Workers of all types are fed up and done overpaying for healthcare.

On the newest episode of ClaimTalk, we dig into why even the highest earners are demanding alternative health plan solutions. Find out how a dual-option strategy eases this pain point — by letting employees choose between lower-cost reference-based pricing and expensive traditional network fees.

https://t.co/NlyM9A3uZ1

#ClaimTalk #DualOption #RBP

[ClaimDOC @ClaimDOC_RBP]

Creativity was in full bloom this Earth Day.
Our team took a break to decorate flower pots and absolutely delivered.

#ClaimDOCCulture #EarthDay

[ClaimDOC @ClaimDOC_RBP]

What changed an RBP skeptic’s mind? Dual option.

Paul Saunders (Saunders & Company) joins ClaimTalk to share how the dual‑option strategy changed his perspective on RBP. Watch to find out why RBP doesn't have to be all or nothing.

https://t.co/IZ74R5apSZ

#ClaimTalk #DualOption #RBP

[ClaimDOC @ClaimDOC_RBP]

Cost containment shouldn’t limit access.

With DirectAccess+, it never does.

Nearly 14,000 provider nominations and a 97.2% acceptance rate in Q1 prove access is being built — intentionally.

#Why ClaimDOC #PaveTheWay #DirectAccessPlus

[ClaimDOC @ClaimDOC_RBP]

Traditional health plan or a lower-cost RBP? Which would employees choose?

Unsurprisingly, most vote with their paycheck.

On this month’s ClaimTalk, Omar Arif & Stephanie Mohr join Paul Saunders (Saunders & Company) to explain why dual-option plans deliver real savings without full network replacement.

#ClaimTalk #DualOption #RBP

[ClaimDOC @ClaimDOC_RBP]

To win at Connect 4, you have to think four moves ahead.
That’s the same mindset our team brings every day to building sustainable health plans.

Congratulations to our Connect 4 tournament champs:
1st Place: Amy, Yasin, Jilli and Meena
2nd Place: Ben, Corbin, Morgan and Bridget

#ClaimDOCculture