Feb 2021 | Get the latest from the best RBP advocates and auditors
Industry Perpectives
Mark Nickerson, ARM
Vice President of Business Development
My journey from BUCA to ClaimDOC
The US healthcare system provides an undeniable quality of care, technology, and providers. Yet, these providers are disconnected from the member by a maze of PPO’s that alienate and micromanage care, breed confusion and increase cost and stress on all sides. Perfect healthcare does not exist, however, after over 20 years of working in the PPO world, I set out on a journey to find the best mechanism for efficiently delivering healthcare solutions to plan sponsors. I found the solution with ClaimDOC.
From the 1940s to today, countless government and private solutions have promised efficient, quality, and affordable healthcare and failed to deliver. Today we have reduced the number of viable health carriers to a catchphrase, the BUCA’s. Government regulatory moves have rushed the consolidation of provider and hospital groups into powerful market forces using complicated algorithms to maximize revenue and gaining strong market positions, which leverage BUCA’s into constantly increasing reimbursements.
Cost transparency, billed charges, discounts, profit, quality metrics, and more are all extrapolated hokum. We all know that change is necessary, and for the fortunate few that want to fight for change, meaningful change is possible with ClaimDOC. Those who worry that change creates too much noise are dismissing the current noise and hoping change will occur from the same sources that made the problems and profit off the current state of confusion. 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. East Hartford, CT
Outpatient clinic services for three (3) dialysis treatment
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
I want everyone to know how lucky I am to have Mary as my member advocate. She is undoubtedly the most compassionate, professional, and courteous person I’ve had the pleasure to talk with on the phone. When I have questions about my plan, she gives me all the answers I'm looking for. Having a member advocate like Mary makes all the difference and is appreciated.
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ClaimDOC, 506 Third Street, Des Moines, IA 50309, 1-888-330-7295
