Faqs

Frequently Asked Questions

Faqs

We don't yet know all your questions. But we certainly have answers.

Claimex began as a specialized firm focused solely on one thing: reviving denied HMO claims that others gave up on. Over time, our clients asked for more services, faster authorizations, better contract negotiation, and help with navigating payer issues across the board. Today, we offer three powerhouse divisions: Claims Revival, Case Management & Authorizations, and Contracting & Credentialing — all working together to get you paid faster and more completely.

No. As mentioned above, Claimex works to revive denied claims and obtain reimbursement. This process takes place only after you try billing the HMO and fail to collect reimbursement. We are not here to compete with your billing department or billing company; we are here to help shoulder the burden when dealing with complicated billing issues.

There are no upfront hiring costs or fees whatsoever. Claimex works on a commission-based, zero-risk payment platform. We don't collect any money or payment unless you do. Our fee is generally a flat percentage of the HMO payment – paid only once it is obtained – of the amount you would have otherwise never received. In essence, it doesn't cost to hire us – it actually pays.

Absolutely nothing. If, on the rare occasion, we are unable to revive your denied claim and obtain payment, then you do not owe us anything at all. But our track record of success clearly indicates that we will generally revive the claim and help you collect your rightfully-owed reimbursement.

We serve the full gamut of healthcare industry clients. From large hospitals, to midsize nursing homes, to boutique medical clinics, Claimex strives to provide every client with top-notch results. To date, Claimex has cumulatively collected over $143 million in denied claims and serviced over 300 medical facilities.

Our close relationships with the senior executive teams at numerous health insurance carriers allow Claimex to maintain an open line of communication with key decision makers. This includes Medicaid, Medicare, as well as HealthFirst, VNS, WellCare, and other prominent industry players.

We are currently working with healthcare facilities across 19 different states and are rapidly expanding our coverage areas. Click here to view a full map of all the regions presently being serviced by the Claimex team.

Your in-house billing department is, without a doubt, juggling multiple billing tasks. Our role at Claimex is to work alongside your existing billing team and help tackle the tough-to-collect claims that slip between the cracks. This frees up your team to work on other important day-to-day tasks like porting charges and posting payments, to census documentation and adjusting ledgers.

You will receive the claims reimbursement directly from the carrier. We only work to revive the claim and get your carrier to pay it out; the reimbursement is sent to the original biller. Once you obtain the payment, we simply receive a predetermined percentage for our professional work.

Simply call our knowledgeable claims revival specialists at 347.425.1177 to learn more about how Claimex can help boost your profit margins or send an email to info@claimex.com