TrueClaim

You saw an out of network provider and ended up receiving a massive bill. Out of network services can result in unexpected charges for the member. We pulled out the language from a plan document that states this directly. While the plan might not cover these charges, you still have the right to appeal unreasonable or wrong charges. Have you tried calling back and asking for a discount?

There is nothing Elizabeth Gill can't do. Since joining us in December, we've witnessed her ability to: ✅ Solve member questions and concerns with empathy and urgency ✅ Build lasting and productive relationships with customers ✅ Accurately adjudicate medical claims and process payments ✅ Build end-to-end workflows and standard operating procedures 😁 Have fun working With ~20 years of experiences across claims adjudication, account management, and sales, Elizabeth is a true unicorn. But what really impressed us was her desire to create flawless member experiences that are unlike anything the insurance industry has seen ever before...as one customer put it, "it doesn't go unnoticed..." Welcome again, Elizabeth Gill, we are lucky to have you on the team!

What’s your one message to employers? I asked Barbora P Howell from TrueClaim at the You Powered Conference what she wants employers to know. Here’s what she had to say: What’s your message to employers? Drop it in the comments. #EmployeeBenefits #WorkplaceWellness #YouPowered

We are excited to officially announce our partnership with Rezilient Health. Together with Danish Nagda and his team, we make it easy for members to solve 90% of their needs virtually while getting specialty consults and referrals to manage more complex conditions or preparing for a planned procedure. The best part? No cost to members and positive ROI for employers.

It was an honor to participate in the EHIR Academy Pitch Competition. We are thrilled to be paving the way to a future of transparency in healthcare.

We are grateful to be participating in a conversation with world-class advisors and the next generation of solutions for self-insured employers.

We recently saved 31% of healthcare costs for a medium-sized employer. How did we do that? 1️⃣ Understanding priorities No two companies are created equal. In this particular instance, the employer was interested in savings costs. That said, they were not willing to do so at the expense of benefits their employees could access. For example, they wanted to make sure everyone has the opportunity to stay with their preferred providers. 2️⃣ Supporting a custom plan design We worked tirelessly with a benefits advisor to bring together a set of solutions that would be the perfect fit for this particular company. In the end, we offered First Health as the network for providers and implemented a no network arrangement for facility changes (~hospitals). We were also able to support and integration of virtual primary and urgent care benefits, plus on-demand counseling, which added a premium feel to the overall benefits package. 3️⃣ Embedding incentives for members We made sure that members knew they could access additional benefits by engaging with our embedded care navigation team. By calling or accessing benefits through the TrueClaim app, employees can save a lot of money while taking better care of their own health. Did it work? The verdict is still out, but we think that 31% saved is a good starting point 🚀

Here are three takeaways from walking the aisles of #SIIA National Conference: 1️⃣ Insurance administration remains highly interdependent In healthcare it's oftentimes true that two companies can both be customers and vendors of each other at the same time. I might sell you our member facing app but buy your data to feed into some features in the app. We're here to report that this hasn't changed and the community is as strong as ever. 2️⃣ Speed is of the essence Where in the past it would be normal to return stop loss quotes within 3-4 weeks, we're seeing many companies commit to <7-day timelines even during the busy renewal season. This is a welcome change as it translates into a better experience for employers who are looking to evaluate their options fast. 3️⃣ AI has arrived How do you use AI? Will AI touching claims yield plans non-compliant? Are you building AI agents for claims? Is AI better than humans for some use cases? Being highly regulated, healthcare tends to be slower to adopt new technologies and we were excited to see that the time is now. 🚀 2025, bring it on. We are ready!

We are packing and can't wait to get to Rosetta Fest this week. If you are participating, check out our booth or schedule some 1on1 time with us directly. https://lnkd.in/gCdn88ZF

Do you work at the top of your license? ✅ If you are a benefits consultant, you want to spend time with customers and members or focused on high level benefits strategy. ➡️ This means we have to make it easy for you to do the rest. 🎉 We've now made TrueClaim’s new group onboarding experience so easy you won’t be able to finish your morning coffee by the time you’re done. It's the small things that add up and make all the difference, and we're relentlessly at work making them happen. 👉 What would you like to see next?