Hi ,
Thank you for reaching out to us. We are sorry to hear about your client’s claims denials. Our claims team can offer some assistance to your clients at our hourly claims management consulting rate of $150 an hour with a 2-hour minimum paid at the time service is requested.
We could assist your clients in several ways on an hourly basis. We can work on correcting or appealing only the denied claims needed or upon access we find are denied or, we can look at all the medical maternity claims for the entire pregnancy/journey, depending on which concerns this match has, and for as many hours they would like assistance for. (please note this service rate does cap at our full Journey Claims Management service fee of $1,750)
If it is agreed to select our services, first, we generally request copies of any denied claims/EOB’s and or online access to the insurance claims in question, related provider invoices and a copy of her insurance policy booklet to see if the denials can be appealed. Upon review of the booklet if appealing is not an option, we would offer to assist in getting providers to agree to cash pay negotiations. Additionally, in order to perform this service, we would request the member sign a HIPAA form authorizing us to speak to them on her behalf to insurance and needed providers to resolve the claims issues.
Please let us know if the client chooses to move forward, and feel free to reach out to us with any questions you may have about this process.
Claims Coordination Team