There’s a lot of buzz about stop-loss renewals right now. I love seeing the different perspectives, but most of them lack insight and information. For instance, no one is talking about the impact of retrocessionaire rates, that the markets you go to matter, and why you should do an alternate market check.
November 2025 | Get the latest from the best RBP advocates and auditors
Industry Perspectives
Sam Apland
Business Development Manager
Keys to Controlling Renewal Rates
There’s a lot of buzz about stop-loss renewals right now. I love seeing the different perspectives, but most of them lack insight and information. For instance, no one is talking about:
In 2022, Featherlite Trailers partnered with ClaimDOC to implement a new reference-based pricing health plan for its employees. It’s no secret that moving to an RBP plan can come with friction but, with Shannon Westin, SHRM-SCP leading its human resources department, Featherlite didn’t just endure the change, they owned it.
Westin joins Danielle Young and Amy Hansen on ClaimTalk this month to share how taking the time to truly understand the plan and being proactive in resolving potential issues caused watercooler talk to shift from uncertainty to appreciation.
Auditing and Monitoring Necessary for Effective Compliance, Ethics
Everyone working in the field of healthcare compliance understands one of the seven key elements of an effective compliance and ethics program is auditing and monitoring.
But why is auditing and monitoring so important? Because coding, billing and documentation errors frequently result in fraud, waste and abuse. Without an effective auditing and monitoring process in place, there is no way to measure the impact of provider billing, coding and documentation errors in an organization and the ability to identify what steps are needed to correct them from recurring. In this Audit Spotlight, we focus on the role of auditing in reducing fraud, waste and abuse. Read more.
DirectAccess+® Savings
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.
Valhalla, New York
One-day hospital stay for the treatment of stenosis peripheral vascular stent 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
"Alea has been amazing through my breast cancer diagnosis. I have had a lot of issues with the doctors’ offices and facilities not doing things properly, causing issues with scheduling and billing. Alea has taken care of it all for me. I am very appreciative and super happy that she is my advocate. If I had to do this myself, I probably would have given up by now."
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ClaimDOC, 3200 Westown Parkway, West Des Moines, IA 50266, 1-888-330-7295
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