Dec 2020 | Get the latest from the best RBP advocates and auditors
Industry Perpectives
Ben Krambeck
CEO/Founder
Looking Back and Going Forward
As we look back at 2020 from a business perspective, it’s almost mind-numbing to summarize the meaningful events that unfolded. Ultimately, I’m so proud that we accomplished our greatest period of organizational growth and refinement over the last six months despite all the noise and uncertainty. The idea of sharing my feelings externally was met with some internal pushback, “talking about improvement could lead people to negative conclusions.” I completely disagree with that sentiment and believe any organization that isn’t continually challenging itself to improve is failing or declining. It’s essential for reference-based-pricing (RBP) companies to be focused on serving their distribution partners and evolving with the changing landscape of healthcare.
While we witness our industry competitors chase money, revenue, and investor satisfaction over broker, client, and member satisfaction, we remain focused on our mission to deliver the most comprehensive RBP solution in the market at the lowest fee structure possible. Our comprehensive solution is designed to give members the best possible experience while managing both the medical plan's expenses and liabilities. Feedback from brokers continues to be that our program gives them the best opportunity for successful delivery and RBP client retention.
I’m sure some of the PEPM (Per Employee Per Month) lovers out there are groaning about our fee structure. We are not all things to all people. That is fine if clients want savings and are willing to sacrifice member experience and take on unknown future litigation risks. The interesting part to me has always been wondering if those clients ever receive a cost-benefit analysis regarding their decision. Read More...
Client Savings
Comprehensive line-by-line claim auditing by healthcare professionals is used to uncover errors typically not caught. ClaimDOC publishes a sample of five recent client savings audit results bi-monthly. See the savings below and know that together we can make healthcare affordable.
1. Blackburg, VA
Hospital outpatient services for the surgical repair of umbilical and inguinal hernias
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 Broker
Karson on your Member Advocate team has been outstanding to work with. We had a difficult member and Karson’s effort to diagnose the issue and diligently keep the member informed is greatly appreciated. Because of his work our office no longer receives calls from the member and we are grateful for his help.
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