ClaimLinx claims report schedule

2022 Claims Report Schedule Available

The Claims Report Schedule for 2022 is ready for administrators to review. Click to download the report: ClaimLinx report_schedule2022.

What is the Claims Report Schedule?

This is the schedule the billing department uses when invoicing clients for claims. Once ClaimLinx receives the funds for the claims processed within the period detailed in the report, the billing department begins processing payment for those claims.

Administrators should refer to this document throughout the year to see when to expect an invoice for claims. Administrators can also use it as a basic outline for the beginning of the claims payment process. Remember, ClaimLinx invoices based on the Process Date, not on the Received Date nor on the Date of Service. That is why it’s very important for members to send claims documentation as soon as possible.

What is a claim’s Process Date?

The Process Date is the date a claims processor reviewed and adjudicated a claim. It is the date the claims is processed into the ClaimLinx system. Members and administrators should allow 5-10 business days for processing after the date the claim was received. The maximum time a claim can take for processing is 90 days.

Members should send all claim documentation as soon as possible to ensure timely processing and payment, if applicable. For the best results, members should send the Explanation of Benefits from their primary insurance carrier AND the bill from the providers office. You may contact our claims team for questions regarding a claim or proper documentation. Contact help@claimlinx.com or start chatting now by clicking the button in the bottom right corner of the page.

What happens after ClaimLinx sends the Invoice?

After administrators receive the invoice, ClaimLinx awaits payment before paying claims. Our billing team expects payment for claims in the form detailed in your company’s contract. We accept payment via ACH, credit card, wire transfer, check and prefunding. If you would like to change how you pay your claims invoice, contact service@claimlinx.com. We are happy to talk to administrators about what the best option is for their company.

Please remember, any delays in payment for a claims invoice causes a delay in sending payment to providers and/or members. See more about the entire claims process, from start to finish.

New Client Service Manager Amy McDonald

We are excited to announce a new addition to the ClaimLinx team!

Amy McDonald is our new Client Services Manager. She has over 26 years of experience primarily working with clients in the Professional Employer Organization Industry as Director of Client Relations. She brings a wealth of knowledge on education, problem solving and best practices to ClaimLinx.

Amy oversees all operations of the Service Department and is in charge of all escalated issues, client retention and customer experience. She also supervises the Field Managers, Eligibility Specialist and Client Coordinator. Your Field Manager will still be the first point of contact in servicing your account. Amy will be reaching out personally to introduce herself.

Amy’s contact information is below. Feel free to reach out to her.

Amy McDonald

Client Service Manager
Phone: 513-985-4466
Email: amcdonald@claimlinx.com

Full-Service Insurance Agency ClaimLinx

How A Health Insurance Agent Can Help You Find the Best Plan for You

Ohio residents pay an average of $471 a month for their health insurance if they’re 40 years old. When you go through the marketplace or exchange, you’re at the mercy of an algorithm that uses a few base questions to show you the options that you have available. A health insurance agent in Ohio can work with you on a deeper level to find the right plan for you.

How a Health Insurance Agent Can Help You Find the Best Plan for You

Help Navigate Marketplace Plans

Marketplace plans are available that may best suit your needs. An insurance agent can help you browse through these plans and explain the options that you have available to you. Since the agent’s services come at no cost to you, the information they provide can be invaluable.

Alert You to Non-marketplace Plans

The marketplace is just one avenue where you can search for plans. Sometimes, the best plans are not listed on the marketplace. The insurance agent will assist you in finding these plans so that you have a clear picture of the healthcare options that are available to you.

Assist You with Subsidy Plans

Subsidies may be available to you, and a health insurance agent will be able to:

• Recommend subsidies that may fit your needs

• Assist you in applying for these plans

• Lower your out-of-pocket expenses

Most states allow agents to access plans so that they can provide the best options to their customers.

The agent can help you both apply for these subsidies and may enroll you into these plans to save you significant time in the process.

Advocate on Your Behalf

When you sign up for a plan, you’re often left alone and have no one to help you the following year. However, an agent can work as your advocate year after year so that when open enrollment comes around or there’s a major life change that you go through, the agent can help you find the best plans available.

Additionally, they can:

• Ask questions about benefits

• Walk you through the claim process

Learn and Understand Your Needs

Your needs are unique, and when you go through the marketplace, your needs are often not considered in the same way that an insurance agent can offer. An insurance agent will work to understand your unique needs so that they can:

• Narrow down plan options

• Eliminate plans that won’t work for you

• Find only the best insurance options available for your needs

Often, the insurance agent will assist you in finding the plan that matches your needs and budget. However, when you sign up for the marketplace and don’t work with an agent, you’re missing out on potential plans that may offer you better coverage and benefits.

Ohio’s health insurance costs are expensive, but you need coverage to ensure that if a medical emergency does occur, you’ll receive the care you need most. Health insurance agents in Ohio can help you find a plan that best fits your unique needs and budget. They’ll even help you work through subsidies that can save you money.

 

 

How the ARP makes marketplace health plans more affordable for older buyers

Ohio Senior Health Insurance: What Is It And Do You Qualify?

Seniors spend an estimated $6,668 per year on health care, according to the Bureau of Labor Statistics. It’s the second-biggest expense for those aged 65 and older, and without adequate senior health insurance, medical costs can quickly become unaffordable.

For seniors in Ohio, it’s important to understand your health insurance options and whether you qualify for senior health insurance.

What is Ohio Senior Health Insurance?

In Ohio, qualifying seniors can apply for Medicare, a federal medical insurance program for those aged 65 and older. This insurance program helps cover the cost of medical care, including routine doctor visits.

With Medicare, you have two main options:

Original Medicare

Original Medicare includes:

• Part A: Hospital insurance that helps cover the cost of hospital care, hospice care, care in a skilled nursing facility and home health care.

• Part B: Medical insurance that helps cover the cost of doctor visits, outpatient care, medical equipment, preventive services and even home health care.

With Original Medicare, you can choose to join Part D, which is a drug plan that can help to cover the cost of prescriptions. You can also see any doctor or hospital that accepts Medicare anywhere in the country.

Medicare has out-of-pocket costs, like 20% coinsurance. To help with these costs, there is Medigap (Medicare Supplement Insurance) or coverage from a former union or employer.

Medicare Advantage

Medicare Advantage, or Medicare Part C, is a plan provided by a private third-party and serves as an alternative to Original Medicare. These are bundled plans that typically include:

• Part A coverage

• Part B coverage

• Part D coverage

Although these plans may have lower out-of-pocket costs compared to Original Medicare, you will likely need to use doctors and hospitals within the plan’s network. However, Medicare Advantage may also cover some things that Original Medicare does not cover, such as:

• Vision

• Hearing

• Dental services

The Ohio Senior Health Insurance Information Program (OSHIIP)

It can be challenging to choose the right senior health insurance option for you. The Ohio Senior Health Insurance Program, or OSHIIP, provides Medicare beneficiaries with unbiased and free:

• Health insurance information

• Education about long-term care insurance, Original Medicare, Medicare Advantage, part D and supplement insurance options.

• One-on-one counseling.

OSHIIP has helped more than 435,000 Ohioans and saved them more than $32 million in health insurance costs.

Do You Qualify for Senior Health Insurance?

Medicare is available to all seniors aged 65 or older. You can sign up for Medicare three months before your 65th birthday.

To qualify for senior health insurance, you must also be a U.S. citizen or have been a legal resident of the country for at least five years.

Individuals under the age of 65 may also qualify for Medicare in certain circumstances, such as receiving a disability pension from the Railroad Retirement Board, suffering from certain medical conditions or having permanent kidney failure.

Senior health insurance helps cover the cost of major medical expenses, routine doctor visits and, in some cases, long-term care. If you’re unsure whether you qualify for coverage or want to learn more about your options, OSHIIP can help.

 

Dental-Insurance

What Is Principal Dental Insurance?

Principal Dental insurance plans offer enrollees the opportunity to join an employer’s group dental coverage. In addition, employers can choose to customize their dental coverage to fit in their annual budgets.

What Is Principal Dental Insurance?

As a group dental insurance provider, Principal allows businesses to:

  • Pay for the entirety of their employees’ insurance
  • Cover just part of the insurance premiums
  • Cover none of the insurance premiums

Nationally, 50% of dentate individuals between 18 and 64 had some level of dental insurance in the past 12 months. As the job market remains highly competitive, employers that offer group dental insurance improve their odds of hiring top-tier talent.

Principal Dental offers:

  • Preferred Provider Organizations (PPO)
  • Dental Health Maintenance Organization (DHMO)

Depending on the state, various options may be available.

Customizable Options for Businesses

Group dental insurance plans have numerous customizable options that influence the business’ expenditures and bottom line. When determining the right choice for your business, you’ll need to customize:

  • Coinsurance
  • Deductibles
  • Options

Businesses can alter the deductible of the employee to match the financial constraints of the business. Higher deductibles for employees mean lower expenses for the company. Management must sit down and come up with a custom plan that maximizes the group dental benefits offered while also remaining within the business’ overall budget.

Principal Dental has an annual maximum refreshment as well as deductibles being waived under certain conditions. Employees also gain access to a mobile app that outlines their benefits and makes it easy to obtain ID cards.

How Group Dental Plans Work with Principal Dental Insurance

Principal Dental follows a standard, three-category system for dental services:

  1. Preventative. Routine exams and cleanings are part of the preventative care offered through Principal Dental and are 100% covered through insurance.
  2. Basic. Cavities that require fillings would fall under the basic care category, where 80% of the cost is covered by insurance and 20% by the employee or employer.
  3. Major. A major procedure, such as a dental bridge or root canal, will have some costs covered by insurance and the rest an out-of-pocket expense for the employee.

Employees will receive a comprehensive list of procedures that are covered through their insurance and which are not. Transparency allows employees to opt into group plans with confidence that the procedures they need the most will be covered as long as they’re listed.

When employers offer group dental insurance through Principal, they’re joining a massive network of nationwide dental providers that their employees can leverage to maintain optimal dental health.

In-network and non-network coverage options are offered, and out-of-network deductibles are combined to quickly help employees meet their deductible limit.

Principal empowers employees to recommend their own dentist for inclusion in the network. If an employee is happy with their own dentist, the ability to continue using the same dentist is crucial.

At ClaimLinx, our consultants can help business owners find group dental insurance that meets the needs of their organization.

Small and large businesses that offer group dental insurance can increase applicants for a position, improve employee satisfaction and boost employee retainment through insurance options.