이 팟캐스트 소개 🔗
Welcome to ClaimTalk, the official ClaimDOC podcast, where we dive deep into the complex world of unbundled health plans. Together with industry experts, we'll pull back the curtain on a wide variety of cost containment topics. We'll provide listeners with a lot of information with a few shenanigans along the way.
최신 에피소드 🔗
Reference-based pricing has come a long way from its early days.
While eye-popping savings got employers interested, RBP created enough disruption to make you wonder if the savings were worth the headaches. Then the model grew up.
Jeff Kweder, president of Shepherd Insurance, and Shepherd Advisor S…
이전 에피소드 🔗
Roughly one in five medical claims is denied, yet only a fraction of patients ever appeal. Denials aren't just an administrative headache. They're becoming a barrier to necessary care in a system that makes it confusing for people to challenge the decision.
On this episode of ClaimTalk, C…
Medical claim denials are necessary to protect plan dollars from abuse, but for patients they can mean delayed treatment, financial hardship and life-altering uncertainty.
On Episode 26 of ClaimTalk, we welcome Zach Veigulis, co-founder and Chief AI Officer of Claimable, an AI-powered medical claim…
Can the problems with health insurance actually be fixed?
In Part 2 of this ClaimTalk conversation, CEO Ben Krambeck, Vice President of Provider Relations Brad Hansen and Vice President of Audit Services Cynthia Swanson continue unpacking how we got here — and what it will take to change course. Bu…
Purchasing healthcare didn’t become this complicated overnight. So how did we get here? Our industry experts — CEO Ben Krambeck, Vice President of Provider Relations Brad Hansen and Vice President of Audit Services Cynthia Swanson — join Danielle Young on a new ClaimTalk to trace the policy decisio…
Convincing consultants to bring reference‑based pricing to clients isn’t easy. Paul Saunders, executive vice president at Saunders & Company, knows firsthand as someone who once was "totally opposed" to RBP. That changed when he saw how a dual‑option approach could work: pairing a tra…
Who's a good third-party administrator? There are many to choose from, but far fewer that consistently deliver when it matters. And the difference between a good TPA and a mediocre one often determines whether a health plan works exceptionally well or frustrates everyone it touches.
Our last t…
Selecting the right vendors for a reference-based pricing health plan isn’t an exact science. At the end of the day, it often comes down to experience, discernment, and the ability to read the signals vendors give off long before the contract is signed.
In this episode of ClaimTalk, Emma Fox, CHVA …
Building a successful self-funded health plan demands skilled and efficient vendor partners that have the expertise to deliver on their promises. Identifying the best vendors can be challenging, and settling for substandard partners can lead to less-than-desirable outcomes. But how do you find the …
In 2022, Featherlite Trailers partnered with ClaimDOC to begin implementing 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&…
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