Personalized Services
Mixture of interpreting claims, benefits, enrollment and COBRA issues.
Our focus is customer service and medical claims related issues:
- Process claims
- Interpret claims
- Billing disputes
- Interpret benefits to providers and members
Tomica Bailey has over 5 years experience
at Humana’s Home Office in customer care and nationally recognized
as a Top 50 Humana customer service rep; 2 years focused Self -Funded
experience
- Problem Resolution Tracking and Performance:
- More complex customer
care usually resolved in 3-4 days
- Minor customer care claims usually
resolved in 24-48 hours
- ARI uses ACT Notes and History inputs to
track claims
- Information is logged at time of problem input, time
stamped it and note problem owner
- Typical issues include members
not understanding policy and working with insurance carrier for
payment accuracy & timeliness
Our goal:
- Take the “fight” off your
hands saving you time (money) and effort
- Our goal is to head
problems off before they grow and reduce time needed on resolving
certain problems (new employee enrollment waived issues)
- We work
with carriers to appeal claims if denied by carrier
