Carl Mays II, President & CEO, ClaimCare®
ClaimCare is an anticipatory organization with a laser-like focus on the current technical and human-touch needs of its clients while constantly probing into soft trends that may happen and hard trends that will happen. One-hundred percent USA-based, all ClaimCare personnel participate in on-going training and strong process management to ensure the highest quality services to clients now and in the future. ClaimCare’s anticipatory attribute was exemplified several years ago when management observed how one employee’s flu could spread and contribute to lowering company-wide productivity.
ClaimCare spent much time, energy, and money to put into place a fully-tested HIPAACompliant work-from-home infrastructure that would allow employees to perform remotely when needed. This insight allowed ClaimCare to seamlessly go remote when the COVID-19 crisis was announced, continuing to serve clients in a timely and responsible manner.
A Proactive Mission
ClaimCare’s mission statement is, “To collect the maximum revenue for your practice as fast as possible while helping to alleviate costs and hassle for your organization.” This mission has not wavered during the COVID-19 crisis. In business for 30 years, ClaimCare has learned to turn disruptions and change into opportunities and advantages. Facing the crisis headon, it has added additional services to help clients survive and manage difficulties that have arisen.
Carl Mays II, ClaimCare President and CEO, says that prior to the pandemic, the predominant challenges causing hiccups for many medical billing companies and practices were frequent rule changes regarding such things as compliance norms and diagnosis codes, which hamper the spontaneity of medical practices. Additionally, the trend about 15 years ago for practices to move their billing offshore to save money often led to the crippling of the practices rather than adding any advantage in terms of being more effective, efficient, and productive.
The problems in moving overseas, such as communication barriers, security issues, inadequate employee training, and time-zone differences, reveal that the transition hasn’t worked well for many healthcare providers. This is precisely where ClaimCare steps in with its distinctive elements and nuances as a professional medical biller to solve the majority of problems that result from the offshore billing and coding model. In doing so, ClaimCare brings its unique solutions that are designed to support effective communication and offer up-to-date healthcare intelligence and security while delivering the right information at the right time.
Readiness in a Post-Pandemic World
Being a distinct medical billing company that stands out from the crowd, ClaimCare combines its rich experience and expertise with the latest technological advancements to incorporate smarter work processes. Mays says, “We have maintained an excellent track record of success that has allowed us to serve our clients for 30 years without slowing down. We are continually adopting, adapting and looking ahead to expand our capabilities.”
Through solutions that ensure transparency with its clients, ClaimCare is solving both the pre-pandemic and postpandemic complexities with which healthcare providers and payers have to deal, including the frequently-changing regulations and the inconsistent economic incentives.
Helping Healthcare Professionals Focus on Medicine Instead of Medical Billing
In its products and services portfolio, ClaimCare offers robust solutions. Beyond basic medical billing, it provides credentialing, coding, auditing support, consulting services, system support, and more.
ClaimCare offers Expedited Billing Solutions that quickly resolve issues like loss of crucial billing by a client’s employee or cases where claims have not been submitted by the client’s office for weeks. ClaimCare concentrates on specialty and family office-based physicians, along with freestanding facilities like ambulatory surgery centers, imaging centers, infusion sites, and others.
We have maintained an excellent track record of success that has allowed us to serve our clients for 30 years without slowing down. We are continually adopting, adapting and looking ahead to expand our capabilities
While focusing mainly on mid-range clients requiring a lot of outsourcing, ClaimCare can also serve the needs of small, one-provider practices and large practices with many providers in multiple locations. The company also provides services for labs and collaborates with rural hospitals, helping them retain doctors by modernizing their technological infrastructure.
ClaimCare can take charge of out-of-control AR to prevent revenue loss. The solution helps in regaining control of a poorly managed billing operation and typically increases collections from five to 20 percent, depending on the situation. Furthermore, the company’s impressive billing solutions eliminate the trial and tribulation of in-house billing employees and provide a solid medical billing solution for new practices and facilities.
Mays explains that although the company provides an à la carte offering, it tailors the solutions depending on a client’s needs. ClaimCare’s dedicated client on-boarding teams are further categorized into special project teams that focus solely on understanding a client’s problems and how to solve them. ClaimCare makes efforts to deeply understand a client’s approach to solve the issues and charts a course that is beneficial to both the client and ClaimCare.
During the COVID-19 crisis, ClaimCare added to its impressive portfolio by offering to assist clients in making patients aware of the telemedicine option; in scheduling new telemedicine visits if a client’s scheduling staff is unavailable; in taking over insurance verification and pre-authorizations; and in stepping up to the plate for clients who have asked ClaimCare to only perform clean-up projects, but now realize they can’t keep up with current billing and followup. ClaimCare has informed clients that considering its solid position during disturbing times, it will listen to other specific needs and seek creative, innovative solutions.
ClaimCare also delivers solutions to unconventional clients. As an example, Mays presents a recent case study where ClaimCare worked with a mobile imaging provider. The client serviced in-home patients by taking medical imaging equipment directly to them. However, the client struggled on multiple levels. They had a complex setup and conducted documentation in a proprietary system that focused on their mobile imaging solution.
But the system was not designed for billing processes. The provider lacked the capability of transferring data from the solution to the billing system. ClaimCare utilized its deep expertise in medical billing and helped the client redesign their system and process. With a reconciliation process in place and a solid billing team’s focus, the client was able to improve their collections by 24 percent. ClaimCare was able to consolidate the missed charges, improve billing follow-up, and enhance the overall financial performance of the client.
Orchestrating similar success stories, ClaimCare has also introduced a Trackable Ticket System that allows ClaimCare to record and register clients’ requests to ensure they receive accurate and timely responses. Mays emphasizes, “Our path forward is to continue doing what we do well and assimilating opportunities that materialize. We will continue to leverage artificial intelligence and automation in our solutions to make them more robust.”
What makes ClaimCare so distinctive in the medical billing sector is a combination of being extremely client-focused and 100 percent USA-based; having ingrained longevity experience; creatively dealing with challenges; emphasizing transparent communication; believing “individuals make the plays, teams win the championships;” being proficient with processes that directly serve clients’ requirements; and driven by the vision to hire brilliant minds who have outstanding core skills, deep-rooted knowledge in medical billing, and can proactively communicate with clients to understand and solve their pain points.