When competing for business with brokers new to the space, we still get a lot of questions on our fee structure. CEO and Founder Ben Krambeck expects everyone to understand we are a platform that drives lower TOTAL SPEND and provides premium services.
August 2024 | Get the latest from the best RBP advocates and auditors
Industry Perspective
Omar Arif
Senior Vice President of Growth
Fee Structure — You Have a Better Idea?
Now that ClaimDOC has established itself as the gold standard for full-service RBP with veteran brokers, the bulk of sales come down to getting good rates. When competing for business with brokers new to the space, we still get a lot of questions on our fee structure. CEO and Founder Ben Krambeck doesn’t have a lot of patience for a team member who is uncomfortable with the question. He’ll go into a long dialogue with technical analysis explaining the fees and how all-in clients pay less and get more. He expects everyone to understand we are a platform that drives lower TOTAL SPEND and provides premium services.
I get not everyone’s brain is built like Ben’s or Andrew Soha’s — thank goodness — so I want to explain our fee structure from a different angle. Read more...
Audit Spotlight
Cynthia Swanson, RN, CPC, CEMC, CHC, CPMA
Senior Audit Manager
Excessive Markup of CT Scans — What Is a Fair Charge?
This Claims Audit Spotlight focuses on a patient undergoing computerized tomography services and the associated imaging charges billed by the hospital.
Coding/Billing CT Scans
A computerized tomography scan, also called a CT scan, is a type of imaging that uses X-ray techniques to create detailed images of the body. It then uses a computer to create cross-sectional images/slices of the bones, blood vessels and soft tissues inside the body. CT scan images show more details than an ordinary X-ray.
DirectAccess+™ clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and health plans. The audit team performs line-by-line claim audits to help clients and members maximize their savings. Below is one recent audit result showcasing substantial savings.
1. Ocala, Florida
Two-day hospital stay for the treatment of heart attack and related procedure
Disclaimer – The analysis of any medical billing or coding is dependent on numerous facts, regulations, payer policies and codes, as well as the controlling plan description. The information contained herein is intended to provide a real-life example of opportunities for savings through ClaimDOC services but is not intended to provide medical, legal, or financial advice.
Member Experience
Feedback from a Member
"My member advocate, Sharla, has a great attitude. She is very happy and respectful. Sharla is always such a big help and goes above and beyond with helping me!"
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