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.

Member portal is unavailable, sorry for the inconvenience

Member Portal unavailable

The ClaimLinx member portal is no longer available. We are currently working to return this service to all of our members. We know how important it was to our members to have the portal, so we are very sorry for the inconvenience. The company that originally created the old member portal discontinued this service as of May 2020. The process to create a new portal with all the features members need is a long one. We are working hard to make sure members will have a portal to access in the future and that it will be better than ever.

Once the member portal is available, the ClaimLinx service team will contact company administrators to let them know how members will be able to access the site. We are very sorry the process of replacing the system has taken longer than expected.

What to do without the member portal

For now, members will have to contact our office to receive items or answers they used to get through the member portal. Start a conversation with a team member now by clicking the orange button in the bottom right corner of the website. Remember, our team is only available during regular business hours, that is Monday through Friday from 9 a.m. to 5 p.m. EST.

You may also email help@claimlinx.com and someone will get back to you as soon as possible. Call our office during regular business hours at (800) 858-1772. Using either of these options, you can request an update on a claim. You may also request a copy of any explanation of benefits for a previously processed claim.

Request Documents

For those that using the member portal in the past, you might miss downloading copies of commonly used forms and/or explanations of benefits (EOBs). You can always download copies of commonly used forms on the ClaimLinx website. You can request copies of specific EOBs from the Claims Department by sending an email to help@claimlinx.com, calling (800) 858-1772, or starting a chat conversation now. Start chatting with a representative by clicking the orange button in the bottom right corner of the website.

If you are used to downloading a regular claims usage report, you can make a request for this to be sent to your email on a regular basis. Contact the service team to make this request by sending an email to service@claimlinx.com. This is a temporary service we are providing to make up for the inconvenience of the missing portal. We appreciate your patience with this change.

Check on Claims

Members can check claim status at any time with the claims team by sending an email to help@claimlinx.com, calling (800) 858-1772, or starting a chat conversation now. Start chatting with a representative by clicking the orange button in the bottom right corner.

ClaimLinx processes claims within 10-15 business days of their receipt. Please keep in mind a claim can take between 15-90 days for it to be processed with insurance and then sent to ClaimLinx. For the best results, check that your primary insurance processed the claim before contacting ClaimLinx. See how to file a claim with ClaimLinx and how the claim is processed for more information.

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.

 

Changes for members during Coronavirus “stay at home” order

As of Monday, March 23, 2020 a mandatory “stay at home” order was issued for the state of Ohio, where ClaimLinx’s main office is located. To help prevent the spread of the novel Coronavirus, Governor Mike Dewine has mandated all nonessential businesses close their offices until Monday, April 6, 2020. Claimlinx employees are able to continue working remotely, but we are making some adjustments to our 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. 

Mailing is Changing

It’s a priority for us that our clients and members can access their health coverage services, especially during this time. But it’s also a priority for us to protect our employees. So at this time, we expect delays when it comes to mailing out member ID cards and explanations of benefits (EOBs).

When it comes to member ID cards, we will be sending first a digital copy for the member to use. Then we will send a printed version later. If any member would like a copy of his or her member ID, please contact help@claimlinx.com or start a conversation with a team member now using our Live Chat feature.

Because we do not want too many people in our offices at once, we do expect to have some delays when it comes to mailing documents to members. If you have any questions about a claim or would like to receive a copy of your EOB, you can email help@claimlinx.com or start a conversation with a team member now using our Live Chat feature.

Contact and Processing Will Continue

As employees are able to work remotely and take turns going to our office, we are not anticipating any delays in claims processing at this time. We have worked hard in the last two years to make this process mostly digital. So our claims processors are expected to be able to continue without much interruption.

Related post: Claims processing continues during Coronavirus outbreak precautions

There will continue to be service team members available if you have questions about coverage, a prior claim or if you need a copy of your member ID. As is always the case, if you are sick or in need of medical attention, please contact your provider first.

We would also like to remind our members that local cases of the virus may be putting a strain on the healthcare system in your area. This may have an affect on your regular care. Please be proactive about checking with your provider about changes to any necessary upcoming appointments.

Your local pharmacy may also be experiencing limited hours or delays in filling regular prescriptions. Please check your stock of any regular prescriptions. Be sure to have them filled as early as possible to avoid any interruptions.

Please also remember that members still have access to the member portal for the remainder of March. That means you can still check on claims or print any important EOBs. Starting April 1, 2020, all members will need to reach out to our team directly to get these documents.

Related post: Member portal will be unavailable temporarily

ClaimLinx will continue to communicate with members via email and through our website. Please look for any updates there. Stay healthy and we hope these interruptions in service for all of us are as short as possible.

Claims processing continues during Coronavirus outbreak precautions

It’s an unprecedented time for all of us, but Claimlinx will continue business processes without interruption. There are a lot of changes to daily life for many across the country because of the national outbreak of Coronavirus. Our service teams would like all of our clients and members to know that we will continue to be available during regular business hours.

No Changes to Regular Processes

At this time, ClaimLinx employees are prepared to continue service to clients and members as usual. Our teams are able to work remotely or in offices distanced from each other so as to comply with the social distancing rules outlined by the Center for Disease Control.

That means claims will continue to be processed on schedule. Team members will also continue to be available by phone, email and live chat. We will be maintaining our regular office hours for questions about claims, coverage or other issues.

Related post: How a claim is processed

However, we will be suspending any in-person education or renewal meetings with the service team until further notice. Administrators may contact service@claimlinx.com, if they have not heard from our team already, to talk about alternative options for any upcoming meetings already scheduled.

Changes to in-person meetings are the only adjustments to our services anticipated at this time, though.

Other Precautions You May Need to Take

We encourage all members to be aware of the strain an increase in local Coronavirus cases would put on the healthcare system. That may include both hospitals and providers’ offices. That may mean you may have to reschedule appointments or other planned procedures.

Related post: Avoid surprises on medical bills by preparing for visits

Please also think about any regular prescriptions you or your family members may need in the coming weeks. Many stores have more limited hours, or may be experiencing a higher than normal number of customers.

The healthcare providers in your local area are likely to be changing their approaches quickly as this situation evolves. Please be proactive about any regular services you or your family members may need. Contact your provider’s office about any changes they may be making in the coming weeks.

Resources Are Available

You may to the Center for Disease Control for any guidance on symptoms, protecting yourself and number of cases in your area.

We know this may be a challenging time for many of our clients. But the one thing they will not have to worry about is claims processing. There should be no interruption in our services, but please look out for any future communications from our team members.