Claims Processing
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Make claims less of a headache.
We are introducing a revolutionary health insurance claims processing system built on the Salesforce platform. Say goodbye to fragmented processes and hello to a seamless, one-stop solution for TPAs and carriers alike. With streamlined workflows and powerful automation, we’re redefining efficiency in healthcare insurance administration.
Expertise born from experience.
We serve health plan clients, including traditional insurance, discount medical plans, limited benefit plans, health sharing organizations, and TPAs.
With access to our Smart Healthcare Platform.
Across multiple sectors of the healthcare industry.
Through our bill negotiation services.
Negotiated on behalf of members and their plans since 2007.
Testimonials from members.
See what patients say about Health Admins’ healthcare navigation services.
“Oh my I can’t express in words how awesome this company is! Joseph Marek got my information 5 days ago and called me today and literally blew my mind, he reduced my medical bills from almost $10,000 to $2,877!! This company works on our behalf and they go above and beyond, not to mention, over exceeding all my expectations.”
“Rarely do you encounter customer service on this level. The two people I worked with, Cindy Putnam and Patrick Gaul were quick to return messages and phone calls from the outset of our encounter. All I want is for someone to listen, acknowledge and try to help me. I got that and more from Patrick Gaul. Concise, professional and kind in our interaction.”
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What is health insurance claims processing?
Health insurance claims processing involves reviewing and handling claims to determine the extent of insurance coverage. This process includes verifying the validity of the claim, assessing the details provided, and ensuring that the claim complies with both policy standards and healthcare regulations.
How do I submit a claim?
Claims can typically be submitted online through our secure portal or mailed directly to our claims department. For specific instructions, including necessary forms and supporting documents, please refer to our Claims Submission page or contact our customer service team.
What information is required to process a claim?
You will need to provide complete and accurate information about the healthcare services received, including date of service, provider details, type of treatment, and any related expenses. It’s also important to include your member ID and any other required insurance information.
How long does it take to process a claim?
The time to process a claim can vary, but most are processed within 30 days of receipt. If additional information or documentation is required, the process may take longer.
How can I check the status of my claim?
You can check the status of your claim by logging into your account on our website or by contacting our customer service department. We provide real-time updates to keep you informed throughout the process.
What should I do if my claim is denied?
If your claim is denied, you will receive a detailed explanation of the reasons for the denial. You have the right to appeal the decision by submitting a written request along with any additional supporting documentation within the timeframe specified in your denial letter.
Are there any tips for ensuring my claim is processed smoothly?
Yes, submitting complete and accurate information is crucial. Additionally, make sure to keep copies of all documents related to your claim, submit your claim promptly, and follow up regularly if you haven’t received a response within the expected timeframe.
Who can I contact for help with a claim?
Our customer service team is available to assist you with any questions or concerns about your claim. You can reach them via phone, email, or through our website’s contact form.
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