The American health insurance system is complex and layered with inconsistencies. Whether you are a patient or care for one, managing medical claims can be challenging and time-consuming. A wrong decision can prove costly to your health and finances. Before you tackle the complexities of our health insurance system, consider adding a Claims Assistance Professional to your team.

Claims Assistance Professionals (CAPs) advocate for you with your insurance company and providers. With years of medical claims experience, a CAP is your champion, stepping in as needed to resolve problems and facilitate claims payment. CAPs help ensure that you receive all the health insurance benefits to which you are entitled. They make sure your bills are accurate, inform you about your options, and decipher and manage the endless paperwork that often stands in the way of getting your medical claims processed and paid.

If you are uninsured, your CAP will help you negotiate costs of care from providers and keep you from incurring unforeseen charges. Discover the benefits of having a CAP resolve your medical claims issues.

Claims Assistance Professionals Services

Each business independently determines its own scope and cost of services.

  • Challenge denials of claims by insurance companies
  • Organize health insurance paperwork
  • Audit hospital and provider charges
  • Negotiate with providers on patient balances
  • Review medical bills and determine proper payment
  • Review balance billing practices
  • Negotiate providers fees for uninsured patients or procedures
  • File various types of insurance claims (medical, long term care, dental, vision, FSA, HSA, HRA)
  • Track claims to ensure they are accurately processed
  • Contact providers and insurance companies to resolve claim problems
  • Provide assistance for Medicare enrollment
  • Assist in selecting Medicare Part D drug plans and Medicare supplement plans
  • Assist with health insurance options during employer open enrollment
  • Provide education on medical benefits and options