ClAIMS Resolution and Maintenance

   

No matter which type of health insurance plan you have; individual, employer group, Medicare or retiree benefits, I can help you resolve issues with your claims to fit your short term or long term needs. These services include:

  • Reviewing your current health plan for clarification of benefits and to explain how the plan works; out of network benefits versus in network and the deductibles and out of pocket max.
  • Managing all the paperwork involved with medical claiims; EOBs, statements, correspondence/notices from insurer.
  • Tracking and monitoring your health claims, making sure that all your claims are being paid properly by the insurer.
  • Reviewing any claim denials or rejections for possible resolution; depending on the denial reasons.
  • Contacting the medical provider on your behalf to resolve any claim problems.
  • Filing out-of network claims to your insurer
  • Filing an appeal on your behalf
  • Reconcile medical bills with EOBs before making any payments to medical providers.
  • Evaluate Medicare Part D prescription drug plans every Fall.with 
  • Consult and assist with Medicare enrollment issues. 
  • Resolve Medicare problems with claims or eligibility issues.

I can also manage your claims ongoing to fit your long term needs. If you have several out-of network providers who don't bill your insurance, I can file those claims on your behalf and monitor and track their status until you're reimbursed.

  

Why Use My Services?

  • Save money by understanding your plan and how your claims are paid, either to you or your provider.
  • Save time by not having to deal with long phone calls to the insurer or providers.
  • To take the burden off of having to manage your claims, you can focus on your health and not the administrative tasks.
  • No need to be located near me, I can work remotely.

Are you a Fiduciary?

I work with several Fiduciaries who value my services as it saves their office time and money. I can manage your clients' health insurance claims for short or long term and I'm a good asset to have when needing assistance with any health insurance question. Call or email me for more information.

Contact me for a free 15 minute phone consultation and let's see how I can help you!