Medical Claims Management
This is a wide-ranging approach to all financial aspects, offering transparent communication, advocating on your behalf for what is right, and most importantly, providing peace of mind for all parties. Our 20 years of experience and well-established systems offer security.
We provide personalized assistance for all aspects surrounding the maternity coverage and payment of provider bills. Continual monitoring is key for successful completion of a claims management case, with updates and outcome results communicated to all appropriate parties.
Once confirmation of pregnancy occurs, your dedicated Client Success Specialist will request full access to all policies in place and will review the Insurance Explanation of Coverage to determine Coordination of Benefits (if Gestational Carrier has more than one policy in place). Because often the insurance companies are not billed properly due to Coordination of Benefits issues, clients find our Maternity Claims Management extremely valuable in saving time and financial resources.
ASSESSMENT OF CLAIMS AND BILLS
Your Client Success Specialist communicates with providers regarding all billing after reviewing each insurance claim: confirming insurance is applied correctly, correcting any coding issues with providers, and requesting bills be reprocessed with insurance carrier as needed. A hands-on approach is completed for all bills and claims to confirm they are paid correctly and according to the plan benefits, with follow-up as needed with all insurance carriers and providers.
FINANCIAL CHECKS AND BALANCES
Our process ensures the insurance companies pay according to the defined benefits and you are not paying more than you should to providers. The Gestational Carrier can rest assured there are no unpaid bills in her name following the journey. A digital, final report is delivered to the appropriate parties when all claims and bills have been processed and a zero balance has been confirmed with all known providers. This is customarily provided within 8 months following delivery.
One (1) Policy Validation is included as part of Maternity Claims Management, complying with CA Law Family Code Section 7962.
Service is complete when agency contract ends with Gestational Carrier and/or Final Report is submitted to Agency/Intended Parent(s).
Newborn Claims Management Service is provided for an additional fee.