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 firstname.lastname@example.org if you’re an existing client and want to take advantage of some of these services.
Or contact our sales team at email@example.com if you’re not currently a client and would like to make the switch to quality benefits at a lower cost.
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.
As many as 80% of medical bills in the United States contain errors, according to Derek Fitteron, CEO of Medical Cost Advocate, a partner of ClaimLinx. And those errors can lead to an unnecessary increase in a bill’s overall cost. In fact the credit agency Equifax reported that for bills totaling $10,000 or more, there is an average error of $1,300.
A big reason these errors occur is the way healthcare providers classify diagnosis, symptoms and procedures. They use a coding system called the ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification). The system is incredibly complex with mistakes leading to patients potentially being charged for procedures or testing they did not receive or more expensive versions of their care.
Errors can occur on any medical bill, but tend to be found on bills for complex medical procedures, inpatient care, care from a medical specialist or when patients receive care at a facility outside their insurance carrier’s network.
To prevent this issue for all ClaimLinx clients with a Medical Expense Reimbursement Plan, any high dollar medical claims are automatically sent to Medical Cost Advocate for review and negotiation. But employees can also help to combat this issue by being sure to check any medical bills for procedures or testing they do not recognize, especially bills totaling over $1,000.
Members should contact their provider first with questions about any bill. Then if a change must be made to a previously processed claim, they can contact the Claims Department at firstname.lastname@example.org.
Some of this information was taken from an article which featured our partner, Medical Cost Advocate, published in Employer Benefit News. Read the article.
Administrators for the Medical Expense Reimbursement Plan (MERP) sometimes have members reach out with problems or questions regarding their claims.
Here are some tips to give employees if they have questions or issues with the claims process:
- Be proactive – Remind members to check their primary insurance network and any required preauthorization before a procedure or appointment. Changes to networks or primary insurance carrier’s policies can be made at any time during the year.
- Check during processing – A claim goes through many steps before a provider or facility receives payment – see the attached step-by-step diagram – and it’s important to follow all claims throughout this process. Members can check claim status at any time using the ClaimLinx member portal by going to http://www.ClaimLinx.com and clicking the green “Member Login” button.
- Communicate with provider billing – Some provider billing departments have short timelines as to when they begin pursuing patients for payment. If a member is receiving calls from a provider billing department and is waiting for a claim to be processed, he or she can explain this to the office to be noted on the claim.
- Be patient – The process can sometimes take time, which can be frustrating. But it’s important for members to remember there are many resources to help, including the the claims department at your primary insurance carrier and at ClaimLinx. Members may contact the claims department at any time by emailing email@example.com.
ClaimLinx is pleased to announce to all of its clients that we have added a resource for individuals looking for coverage on the insurance market – www.ClaimLinxMarketplace.com.
This site is a one-stop shop for those looking to purchase an individual plan for themselves to:
- See off-exchange insurance plans, which can have broader hospital and physicians networks and additional benefit options.
- Easily compare pricing and plan options available through the individual market and through the federal exchange.
- Speak to an insurance agent to complete the application process and discuss options.
- Find additional insurance coverage such as vision, supplemental and life insurance.
Please feel free to share this resource with any friends or family looking for individual coverage during this year’s open enrollment period. Just tell them to go to www.ClaimLinxMarketplace.com to get started.
As a member or administrator for a ClaimLinx plan, you will continue to receive the personalized service and/or benefits through the employer-sponsored plan. This is an additional resource for those who do not receive coverage through an employer.