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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.

 

 

What is a Pharmacy Benefit Manager (PBM)?

Small businesses that want to save money for themselves and their employees on health insurance coverage may choose a pharmacy benefit manager (PBM) to facilitate smoother prescription drug claims and payments. This type of administration assistance provides various benefits that can save time, headaches, and money in the long term. Before you decide if your small business insurance package should include a pharmacy benefit manager or not, explore all the options so you can truly understand what it can bring to the table.

Pharmacy Benefit Manager Responsibilities

 

In order to offer a viable service as a PBM, the organization must take on certain responsibilities when it comes to interacting with both your small business and see people who take prescription medications specifically.

 

  1. PBM’s negotiate lower costs and rebates for available prescription drugs.
  2. They offer mail order and delivery medication services that allow patients to receive their drugs in a convenient and affordable manner.
  3. They oversee compliance of proper medication usage and collect and analyze data about ongoing utilization of prescription drugs to promote better outcomes.
  4. A pharmacy benefit manager handles distribution of medications from multiple pharmacies and through different small businesses just like yours.

 

Depending on the PBM you choose and the insurance consulting process specific to your company, they may also take on extra responsibilities that help your workers stay healthy without breaking the bank.

 

Save on Small Business Insurance With a PBM

 

According to current business guidelines, small business insurance is required for full-time employees in most cases. Choose the best possible group health insurance plan is a great way to save some money for your company. This also affects how well your employees are cared for when it comes to medical issues and preventative care.

 

No matter what type of insurance program you choose, it always makes sense to look for additional avenues of savings to improve your company’s bottom line. A pharmacy benefit manager introduces an organizational middleman that minimizes costs by reducing base costs, paperwork, and problems related to handling prescription drugs.

 

PBM’s have been around for nearly 20 years and have become more popular as different health insurance rules go into effect. These management groups can negotiate lower costs, which helps both the business and the patient at the same time. This savings and associated services help to improve medication compliance, access to ongoing prescription support for lower income individuals, and improve outcomes for many chronic disease or disorder sufferers.

 

The decision to augment your small business insurance with a PBM depends on a lot of different factors specific to your company, finances, and employee base. Although the responsibilities and advantages of using one may seem like an exceptional idea, you may need some help to finalize the decision. With professional insurance consulting services offered by ClaimLinx, you can explore the specific options that can help you manage prescription coverage, minimize risk to your employees, and save you money on your benefits packages.

 

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.

Man Next to Doctor

You Missed Open Enrollment, Now What?

It’s a sinking feeling many people have had — the open enrollment period for health insurance has ended, and they forgot insurance to purchase a plan for the year. If you missed open enrollment and are now in need of a health insurance plan, ClaimLinx is here for you. There are still options out there for employees, and especially employers.  

 

The 2020 Open Enrollment period for the individual marketplace through Healthcare.gov was November 1st, 2019 to December 15, 2020. Some states, especially those that do not use Helathcare.gov have extended enrollment periods, but most finish by the beginning of February. For future reference, Open Enrollment is on the same dates each year, unless specific extensions are made.

If you did not enroll during this time, individuals can still qualify for a Special Enrollment Period with a Qualifying Life Event. Aside from this option, short-term plans are available throughout the year. They are not perfect, but they are a great alternative to having no coverage at all. 

 

Special Enrollment, or a Qualifying Life Event 

Some people may quаlіfу for a ѕресіаl enrollment реriod to ѕіgn uр fоr hеаlth іnѕurаnсе. Certain lіfе еvеntѕ, lіkе lоѕіng hеаlth соvеrаgе, moving, getting married or a change in income can trіggеr a special enrollment period, which lasts up tо 60 dауѕ. Lіfе changes thаt quаlіfу fоr a special еnrоllmеnt реrіоd gеnеrаllу fаll into three саtеgоrіеѕ: сhаngеѕ in thе household, сhаngеѕ in residence оr losing hеаlth іnѕurаnсе.

 

Qualifying сhаngеѕ іn hоuѕеhоld саn іnсludе:

  • Getting mаrrіеd
  • Hаvіng a bаbу оr adopting a child
  • Getting divorced оr legally ѕераrаtеd аnd losing health іnѕurаnсе
  • Hаvіng ѕоmеоnе in your hоuѕеhоld dіе

 

Qualifying changes in residence саn іnсludе:

  • Moving to a new home in a new ZIP соdе оr county
  • Moving tо thе U.S. from a fоrеіgn country
  • If уоu’rе a student, moving to or from the рlасе you attend school
  • If уоu’rе a ѕеаѕоnаl wоrkеr, mоvіng to or frоm thе рlасе уоu lіvе аnd work
  • Moving to or from a ѕhеltеr or trаnѕіtіоnаl hоuѕіng

 

Qualifying lоѕѕеѕ of health аvеrаgе іnсludе:

  • Lоѕіng jоb-bаѕеd соvеrаgе
  • Losing individual hеаlth coverage
  • Lоѕіng eligibility for Mеdісаіd or CHIP
  • Lоѕіng eligibility fоr Medicare
  • Lоѕіng соvеrаgе thrоugh a family mеmbеr

 

Short-Term Health Insurance Plans

These are a special type of plan that can be purchased when a person is between health plans, outside of open enrollment. Short-Term Health Insurance plans provide temporary coverage for certain situations and can be a chance for some coverage in case of emergency. 

Short-term plans come with a wide range of coverages because they are not required to comply with Affordable Care Act (ACA) guidelines. That means they typically include some coverage for preventative care, doctors visits, urgent care and emergency care. It may also have some discounts on prescription drugs. But because it is not an ACA plan, be sure to read the plan limitations before enrolling on a plan. That will tell you what is covered and can help you decide if it’s the right coverage for you. 

You can shop for a short-term plan now by going to the ClaimLinx marketplace. On the site, you can request a quote and someone will reach out to you to talk about your options. 

 

What Happens Without Health Insurance

As of January 1, 2019, there is no tax penalty for not having a health insurance plan. Technically the individual mandate is still in effect but there is no penalty to enforce it. So it may seem to some like going without health insurance is not a big deal. After all, health insurance plans are expensive and if you don’t use many medical services through the year, it can feel like a waste. 

Health insurance is still important to have, for all those unforeseen moments. No one expects to need their insurance plan. People buy it every year because there’s always a chance that an accident, or even a small medical issue, could cause huge financial damage. 

Shop for a health insurance plan at any time at ClaimLinxMarketplace.com. You can purchase short-term plans or, if you qualify for a special enrollment period, you can also take a look at plans through a regular carrier. 

Full-Service Insurance Agency ClaimLinx

What a Full-Service Insurance Agency Can Do for You

ClaimLinx prides itself on being a full-service insurance agency. We offer employer benefit consulting, group health insurance, supplemental insurance, and individual plan consulting. Our dynamite set of services goes beyond what an ordinary health insurance agency does, such as just writing insurance policies once a year. ClaimLinx explains what a full-service insurance agency can do for you in today’s blog.

Year-Round Consulting

Many health insurance companies only consult with you when you’re shopping for a plan for your workers. That process may take less than a month, and then you don’t hear from the insurance agency until next year when the overall plan renews. ClaimLinx does things differently as a full-service insurance company. We offer year-round consulting to save you money on health insurance as an employer-paid benefit.

Making Money on the Savings

Traditional insurance companies typically make money on fees paid to them when they create the initial policy. That’s not how ClaimLinx does things. We earn money on the savings you generate. Our team works with you to choose excellent health insurance coverage melded with a medical expense reimbursement plan (MERP) to lower your costs. We only accept a fee after you save money. 

Superior Customer Service

If you have questions, feel free to contact ClaimLinx at any time. We respond to your questions, comments, and concerns about health insurance as an employer-paid benefit. Our expert team consults with you year-round, explains health insurance coverage in full, and includes complimentary elite services for our clients. You receive a lot more than just health insurance from our full-service insurance company. You get an entire team backing you up as you strive to deliver a great benefit for your employees without spending your entire HR budget.

Talk to ClaimLinx

Stop settling for an average health plan when you have a better solution. Partner with ClaimLinx, a full-service insurance company that lets you make the most of your options. Call toll-free (800) 858-1772 or contact ClaimLinx for more information.