Cash in on savings on prescriptions

Consultants look at drug costs to find savings

ClaimLinx analyzes each company’s drug usage to find cost-cutting measures. First, it saves employers money. Most importantly, it helps workers be able to afford the medications they need consistently.

Why ClaimLinx Focuses on Rx Costs

Medications are one of the most important tools people have to maintain their health. However, prescription drug costs keep rising each year. By the end of last year, more than 20 generic drugs had a price increase of 29.4%. Also last year, the cost of more than 1,200 drugs rose by 5-6%. It’s a trend that has so far continued into 2021.

What research has shown is that when medication are expensive, people do not fill the prescription or do not do so consistently. In fact, between 20-30% of prescriptions are never filled because of costs. Up to 50% of medications for chronic illnesses are not taken consistently because they’re too expensive. That all adds up to a real impact on members’ health.

That’s why ClaimLinx prioritizes savings on prescriptions. We know it’s important for employees to take their medications consistently to be productive at work. We also know employers don’t have endless funds for drug coverage. To help with that, we focus on finding a balance between the two.

How ClamLinx Saves on Prescriptions

Our consultants get real-time data on prescription usage through our partner pharmacy benefit managers (PBM). Unlike with a standard insurance plan, ClaimLinx sets up a prescription drug plan with a PBM we trust. That allows our consultants to see which medications workers need and how much they cost. From there, our service team has many methods they can use to cut costs on prescriptions. That saves money for both the employer and the employee.

Enrolling in drug coupon programs

One of the ways ClaimLinx cuts costs on prescriptions is by researching drug programs and coupons for medications. These are many coupon programs through the manufacturers and through different pharmacies. There are also cost sharing programs available for those with financial need. We seek these out because they help the employer. But more importantly, they help the employee afford the drugs they need to stay healthy.

Moving members to a new plan

Another cost-saving measure is to move certain members on the plan to new health insurance plans with more prescription coverage or discounts. For some members, it makes more sense for them to be on a more comprehensive plan. The plan may be higher cost, but it will save in the long run if the drugs are expensive. Our agents are seasoned in taking this into account when finding members the plan that’s going to work best.

Finding generic version of drugs

As a part of ClaimLinx’s overall solution, we place an emphasis on educating members on costs so they can be good healthcare consumers. To help with that, we recommend members have an open dialogue with their providers about their prescriptions. We tell members to ask their doctors if they have chosen a brand name drug why that is. Is there an alternative that can achieve the same results. We also help workers research generic versions of brand name drugs, if they are available. Sometimes providers are unaware of the costs of prescriptions so it’s important to talk with them when the drugs are expensive.

Employers: call us for help cutting costs to get through “stay at home” orders

As of Monday, March 23, 2020, the Ohio Governor issued a mandatory “stay at home” order. It comes on the heels of previous business closures because of social distancing guidelines. Like in many states, the order will continue until the beginning of April. It’s all in hopes of stopping the spread of the novel Coronavirus.

But for many businesses it’s already causing severe financial pain.

Remember, ClaimLinx’s primary concern is savings clients money on health insurance. We know how important health coverage is, especially at a time like this. Our consultants are ready to talk you through how to cut employers’ health insurance costs. We know it’s more important now than ever.

Please contact service@claimlinx.com or call (513) 985-4465 to set up a meeting if you are considering laying off employees or cutting their hours.

Changes to Claimlinx’s Service

The mandatory “stay at home” order in Ohio, where Claimlinx’s main office is located, began on Monday, March 23 and will continue until April 6. Claimlinx employees are able to continue working remotely, but we are making some adjustments to our mailing services.

Because we are an Insurance Institution, we are considered an essential business, as outlined in the order. So we will still have some employees going to our office to maintain services. But we are limiting this as much as possible. For that reason, we do anticipate some delays in mailing. 

We expect this primarily to impact mailing explanations of benefits (EOBs) and member ID cards. Temporarily, we will be sending all member ID cards digitally first and sending a hard copy later. Members can always contact help@claimlinx.com if they need a copy of an EOB.

Related post: Changes for members during Coronavirus “stay at home” order

Contact us before cutting employees’ hours

Already we have had clients who are considering placing employees on furlough or moving them to part time. Our consultants already have strategies for how to use this time to cut costs while still providing benefits.

We are here to help companies get through this trying time. Many employers are worried about how long the pause in the economy will last and what affect it will have on their bottom line. We know, too, they are worried about their workers.

Contact service@claimlinx.com or call (513) 985-4465 to set up a meeting. Our consultants will go over your immediate options and any other long-term planning that may be needed.

Some employers may be able to take advantage of already existing rules on coverage to save on insurance premiums in the coming months. Some employers may need to stop providing insurance for any employees who are laid off. We would like to be there to offer our services to help these people navigate the marketplace so they don’t experience any lapses in coverage.

ClaimLinx is here for all of its clients, especially when trying to cut costs because of financial strains.

 

Member portal will be unavailable temporarily

ClaimLinx is making some big changes when it comes to its digital offerings for customer service. Our current member portal has been around for years and has served our clients well. But we have some exciting changes that will require the member portal to be temporarily unavailable.

What to Do About the Change

Starting April 1, 2020, the member portal will not be available. During this time you can reach out to our team by email or using the new chat feature on our website to check on a claim or receive a copy of an explanation of benefits (EOB). Please login to your member portal before March 31, 2020 to prepare for the transition. You may print any reports or other items you need before they become unavailable.

Once the member portal is unavailable, you must contact our team directly to receive anything you would normally get through the member portal. You can reach us by email, online chat or phone.

We apologize for any inconvenience, and our service team is prepared to help with any issues that may occur because of it.

Why We’re Making the Change

It’s important to know we think this change will greatly improve service in the future. The new portal will have improved features that will enhance service. One example is it will send email notifications when claims are processed and EOBs are ready.

If you would like to add your email to our records, to make sure you are immediately enrolled in this new features, fill out the online contact form. More additional features will be coming so please look for these updates.

The new member portal will have all the same features you have grown to depend on. You will be able to view any processed claims and see any EOBs. We also know how important it is for members to see their basic information, including their address and dependents. These details will be available for members in the new system, too.

You Can Still Chat with Us

Don’t forget that during this transition period, you can contact our service team with the new chat feature on our website. Click the orange button in the bottom right corner of the website to start a conversation.

Messaging is available during our regular business hours — Monday through Friday, from 9 a.m. to 5 p.m. EST. If someone is not available on the chat, you can send a message for someone on our team to respond to via email.

We appreciate your patience and understanding during this transition period. Please be aware there are no changes to the claims processing because of this. Claims will still be processed in the same time frame and in the same way. This applies only to members’ access to the member portal.

See ClaimLinx’s Complimentary Elite Services for clients

When it comes to offering a quality health plan, ClaimLinx doesn’t stop with simply writing insurance and administering benefits. Our service team provides more to each client and member because that is what is needed to get the most of a company’s benefits plan.

Now listed on our website are all included services as a part of setting up a Simple Option Solution health plan, the flagship product that allows businesses to offer a comprehensive health plan at a much lower cost.

See details on included services such as medical claim negotiation, medical claim reporting and analysis, member and administrator portals, online application, prescription rebates and coupons and so much more. All of these services are provided as a part of our role as consultant, agency and/or third party administrator.

We know that the work of administering a benefit plan doesn’t stop at the effective date. In fact, that can be just the beginning. That’s why we have added all of these services for clients to take advantage of our team’s expertise. We offer education meetings and materials for all members and administrators because we know how challenging navigating the health insurance industry can be.

It’s our highest priority that our clients are able to get full use of their health insurance. It’s not enough simply to buy great benefits at an affordable cost; members have to be able to use the benefits too.

Some of our clients already know how useful these additional services are. They request reporting to make sure they’re staying on top of any opportunities for additional savings in the future. They refer members with expensive drugs to our service team to search for drug programs that offer coupons or pharmacy locations with cheaper rates. They schedule educations meetings for members to help with the transition to a new benefits plan. If you’re not taking advantage of these services, you’re not receiving all that ClaimLinx has to offer.

Contact the ClaimLinx service team at service@claimlinx.com if you’re an existing client and want to take advantage of some of these services.

Or contact our sales team at sales@claimlinx.com if you’re not currently a client and would like to make the switch to quality benefits at a lower cost.

Due date for 1095 forms moved to March

Tax filing deadlines are coming up so some of you may have employees asking questions about their 1095 health coverage information forms. Please be advised at the end of last year the Internal Revenue Service (IRS) extended the deadline for issuing these forms to March 2, 2018.

This means insurance carriers and other insurance providers have until this date to provide Forms 1095-B or 1095-C to members. This 30-day extension is automatic and does not require any paperwork to request it.

However, this does not mean that employees are required to wait to receive this information to file their individual income tax return. The IRS states these forms can be used to assist in preparing a return but are not required to file.

As a reminder, these forms are issued from the primary insurance carrier on your plan, not by ClaimLinx. If employees have not received this form after this deadline, they can request it from the insurance carrier directly.

If you have received any additional instructions from your primary insurance carrier regarding these forms, such as if your carrier is National General, please follow their instructions for filing as soon as possible.