Key Differentiators

Pave the Way®

Pave the Way® is ClaimDOC’s trademarked proactive healthcare provider outreach program, which begins up to 60 days prior to the effective date. Our Member Advocates create a one-on-one relationship with each member to help them navigate their new plan. As part of the onboarding process, our implementation team explains the reimbursement method and claims submission process to each provider to ensure a smooth transition between plans. On average, 90% of providers contacted through Pave the Way® accept our fair payment solution.

Pave the Way® is the most differentiating aspect of ClaimDOC’s reference based pricing plan (RBP). There’s nothing like it on the market today.

True, Fiduciary Protection

90% average provider participation

ClaimDOC bears costs for risk management for the plan as well as for member legal disputes related to RBP services.

FREE Physician Claims Processing

Unique to ClaimDOC, all provider/HCFA claims under $2,000 are repriced and defended at no cost to encourage and support complete network replacement.

Detailed, Line-by-Line Audits

Our proprietary claims management and audit system is custom engineered to allow for detailed line-by-line audits. Our in-house audit team is comprised of healthcare experts who conduct “eyes on” reviews of all UB-04 facility claims, ensuring maximum savings. Many RBP programs only review balance bills and appealed claims.

No Outsourcing

At ClaimDOC, we do everything in-house, including implementation, provider relations, balance bill support, clinical auditing, legal management, and member advocacy. Our highly responsive Member Advocates guide clients through our program to ensure a smooth experience for all.