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ClaimDOC

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ClaimDOC Products (2)

   
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Reference Based Pricing (RBP)

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Patient Advocacy

Product Description

ClaimDOC is an Audit and Member Advocacy firm. There is way too much inappropriate billing in Billed Charges and the Audit is key to removing that fat. Then we cover the member to the limits of the benefit plan. We support the member and the plan for the life of... Show More

About this product

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ClaimDOC is an Audit and Member Advocacy firm. There is way too much inappropriate billing in Billed Charges and the Audit is key to removing that fat. Then we cover the member to the limits of the benefit plan. We support the member and the plan for the life of the claim, even if the case terminates. We are a Co-Fiduciary which is very rare in the RBP space but a critical box to check if going this direction. We outreach to every provider of every member up front and ongoing and support all balance bills so no member is left confused by what and how to manage feedback from providers.

ClaimDOC is a complete RBP approach using partners in risk, quality, claims payment and Rx, along with others, to make a better solution that is affordable and fair.

Min. Group Size

100 eligible

Lives Serviced

300,000

Average Cost

Average Cost is Locked

16 RFI Questions RFI questions

RFI questions number is Locked

13 Specific Questions Specific Questions tooltip

Lock

Product Features

✓

Flexible reimbursement and contracts

✓

RBP members flexibility

✓

Health plans integration

✓

Service cost comparison

✓

Plan document preparation

✓

Medical management partners

Show All Features

Product Features

×
✓

Flexible reimbursement and contracts

✓

RBP members flexibility

✓

Health plans integration

✓

Service cost comparison

✓

Plan document preparation

✓

Medical management partners

✓

RBP brokers' access

✓

RBP for professional/physician claims

✓

Clinical and benefits advocacy

✓

Member advocacy and guidance

✓

Enrolling assistance

✓

Personal support

✓

RBP education plan

Not Provided.

ClaimDOC Media

ClaimDOC video/presentation/materials Play
ClaimDOC video/presentation/materials Play
ClaimDOC video/presentation/materials Play

ClaimDOC Info

Founded:

2013

Funding Summary:

Location:

West Des Moines, Iowa

Links:

Employees:

225
ClaimDOC was founded in 2013 to offer plan sponsors suffering from the rising costs of healthcare an effective and sustainable health plan alternative. The cost savings component of the program was driven by the principles of reference-based pricing (RBP). However, our... Show More

About this vendor

×
ClaimDOC was founded in 2013 to offer plan sponsors suffering from the rising costs of healthcare an effective and sustainable health plan alternative. The cost savings component of the program was driven by the principles of reference-based pricing (RBP). However, our solution — DirectAccess+® — was designed to be a fully comprehensive alternative to traditional carriers and networks. Elevating member experience was emphasized from the beginning, so it won’t ever get lost in our highly technical operation of auditing medical claims.

Today, employers turn to us seeking to establish fair reimbursement rates for their plans, allowing them to save money and provide richer benefits to their employees. Our perfect blend of licensed healthcare professionals and sophisticated technology utilizes objective industry data to negotiate fair and ethical payments. That process allows us to benchmark costs nationally, establishing fair reimbursement rates for clients across the country.

Our approach creates strong and sustainable health plans and satisfied employees. That technology paired with our team of member advocates and seasoned healthcare professionals ensures each client’s employees have exceptional personalized service. Healthcare providers are fairly reimbursed, and they enjoy working with a streamlined health insurance plan that isn’t an administrative burden.

We support brokers and human resources professionals with communication and marketing materials, understanding that an educated employee makes their lives easier. Employees are encouraged to create relationships with our member advocates and rely on them instead of burdening HR. We help our members understand their insurance and appreciate the full benefits of a self-funded health plan.

We have a remarkable history of helping employers create rich and cost-effective plans for their members. If you’re considering alternatives for your healthcare plan, give us a call.

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