Freelancers Insurance picks ClearHealth cost management system

PRNewswire

NAPERVILLE — Cost containment company ClearHealth Strategies said Freelancers Insurance Company has selected them to provide a Medicare-based repricing program for out-of-network claim management.

The service, in place since January 1, is being utilized to obtain savings on all eligible out-of-network claims.

FIC is a social-purpose insurance company that is wholly owned by the nonprofit Freelancers Union, and aims to provide affordable, quality, and portable group-rate health insurance to Freelancers Union members and their families.  FIC was searching for an outsourced Medicare based repricing program to help them manage their out-of-network claim volume.  FIC was interested in adopting a Medicare program and a new out-of-network program that offers improved consistency and clarity.

“We conducted an extensive review of vendors in the market and found the ClearHealth program to be the one that best suited our members’ unique needs,” said Sara Horowitz, CEO of FIC. ”We were looking for a company that provided more than just Medicare pricing — we needed a partner that could work flexibly with us on program design and nonstandard issues. ClearHealth has proven to be a great decision.”

ClearHealth Strategies offers a complete Medicare-based out-of-network program.  The program includes the necessary levels of configuration and customization based on group, geography, and claims types, as well as the management necessary to comply with any applicable state and federal legislative requirements and restrictions. Complementary services include member advocacy to assist with balance billing issues, appeal/grievance management, and traditional fee negotiation services, where warranted.

“Many small and mid-sized payers and third party administrators lack the Medicare reimbursement and/or general OON management expertise to create an in-sourced solution, and this is where our program fits,” said John Thompson, vice president of marketing at CHS  “We are pleased that we were immediately able to deliver value to FIC through the program and also of the working relationship that has been developed which greatly enhances the opportunities for success,”