What to Pay Your Broker

What to Pay Your Broker

Whether it is LinkedIn or conferences, we are inundated with conversations bashing benefits brokers. I wanted to take an opportunity to flip that around and help plan sponsors reconcile the relationship between sound advice and broker compensation.

The latest episode of our podcast, ClaimTalk , is the first half of a two-part discussion with brokers. If you are involved in the benefits space — as a business owner, in human resources, as a CEO or CFO — you really should tune into these episodes for an inside look at the broker role and the process they go through when considering alternatives. With your responsibility to properly hire and retain a broker, this is tremendous insight for you to understand how that side of the business works. When asked to offer his best advice for other brokers, Mike Kerns, a veteran broker from Ohio, said to always first think about your client and their employees. The fact this even needs to be said — much less is the best piece of advice from an experienced broker — tells you the primary concern plan sponsors should have is a broker’s motivations.?Read more...



The Merit of Auditing Healthcare Claims

Successful auditing of medical claims does not merely identify problems, it also pushes healthcare providers to bill honestly and follow coding and billing guidelines/regulations, assists in the prevention of improper payments, and reduces healthcare spending.

As healthcare costs continue to climb an upward slope, an escalated need exists for closer auditing of healthcare claims to identify egregious charges, improper medical coding and billing errors, duplicate billing, and associated improper claim payments. 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.

Cincinnati, Ohio

Eleven-day hospital stay for the treatment of esophageal cancer and related surgery

Traditional Network Plan

  • Hospital Bill: $245,762.10
  • Median Commercially Contracted Price ?$105,505.07

  • Patient Responsibility 20% Coinsurance: $21,101.01

DirectAccess+

  • Hospital Bill: $245,762.10
  • ClaimDOC Allowable $88,360.82

  • Patient Responsibility 20% Coinsurance: $17,672.16

  • Plan Savings: $17,144.25
  • Member Savings: $3,428.85

More Audit Results

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
"Cori is phenomenal! She is deeply empathetic, communicative and went above and beyond finding a therapist for me. Cori exemplifies what customer service is really about. Thank you for not giving up on your members. Keep it up! And thank you again!"

Subscribe to ClaimTalk

ADVISORS UNLEASHED —?PART 1

Each month, you can look forward to a new episode filmed directly from our headquarters in Des Moines, Iowa.?Subscribe now so you never miss an episode.?

Thank you for sharing this insightful article! It’s refreshing to see a balanced perspective on the role of brokers in the benefits landscape. In my work, I rely on brokers and organizations like ClaimDoc, and it's essential to recognize the key roles we all play in this ecosystem. Two important highlights stand out to me: first, the emphasis on collaboration and understanding the motivations of brokers is crucial. When brokers prioritize their clients and demonstrate a genuine commitment to finding the best solutions, it ultimately benefits everyone involved. Second, the discussion about transparency in broker compensation is vital. It’s important for plan sponsors to engage in open conversations about how brokers are compensated and to appreciate the unique value that only a small percentage of brokers bring to the table. Let's continue to support and uplift each other in this industry, recognizing the hard work and dedication that goes into navigating these complex challenges together!

要查看或添加评论,请登录