Swiftly lay claim to your denied HMO claims.

CLAIMEX

» Only focuses on HMO collections

» Confirmed track record of claims revivals

» Specializes in advocating with HMO entities

» UB04 form coding & reimbursement expertise

» Billing & negotiating team with 15+ years experience

» High-tech tracking system for real-time monitoring

» Pay-only-if-we-collect pricing platform advantage

COLLECTIONS

» Juggles HMO, Medicaid, Medicare & private claims

» No track record of HMO claims revivals

» No personal relationships with HMO entities

» Minimal UB04 form knowledge & experience

» Entry-level collections representatives

» Questionable monitoring systems & oversight

» Charges mandatory monthly service fees

Is Claimex a traditional collections agency?

No. Claimex is unique because we specialize in the revival of denied HMO claims and handle the subsequent case review, analysis, and claims resubmission. Our team doesn't simply hound carriers or people for money. We work hard to understand the underlying claims denial issues, properly revive the claim, and create custom strategies that swiftly navigate the obstacles. We'll often succeed with the claims appeal and obtain reimbursement for you in as little as 8 weeks following the initial resubmission.

So is Claimex a medical billing company?

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.

How much does it cost to hire Claimex?

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.

What happens if Claimex is unable to revive my old claims?

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.

What type of healthcare clients does Claimex serve?

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.

What HMO and insurance companies does Claimex deal with? 

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.

I currently have healthcare facilities in multiple states. Is that a problem? 

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.

Why hire Claimex if I already have an in-house billing department?

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.

Who receives the actual claims reimbursement?

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.