www.claimtek.com 800-224-7450 Copyright © 1996 – 2015 by ClaimTek Systems 3. A large segment of insured people are baby boomers, they number over 79 million born between 1945 and 1964. A majority of boomers have grown up with health insurance and are used to having insurance pay for their healthcare. As they age, they will demand the best healthcare for themselves. They will visit doctors frequently, generating a never-ending river of claims. Furthermore, they will ALL become insured by Medicare once they turn 65; roughly 4 million are joining the ranks of Medicare each year between 2011 and 2030—that’s 10,000 boomers per day who turn 65. By 2030, one in ve Americans will be over the age of 65, ooding our healthcare system with increased doctors’ appointments, medical tests, and the need for durable medical equipment. 4. The insurance industry is complex, confusing, and ever-changing. In the US, there are literally hundreds of health insurance companies, each offering several types of insurance plans. This translates into roughly two thousand insurance plans of one kind or another. Each insurance company has its own type of insurance plan, its own fee schedules, its own reimbursement policies, etc. It is chaotic and confusing for doctors to keep up with. Most doctors’ ofces cannot keep up with the record-keeping and con- stant change of regulations and fee schedules. Eventually, many of them decide to outsource their claims to a specialized billing service like yours. Errors arise in a doctor’s ofce for a variety of reasons. Their in-ofce billing staff may be unqualied or too busy to be consistent in ling accu- rate claims. They may not have a solidied support system in place to answer questions related to specic billing functions or new processes in billing claims. This is avoided with ClaimTek because of the continued one-on-one ongoing training and support provided to each licensee. Ad- ditionally, with our MedOfce software there are safe-proofs built into the system to avoid simple human errors. Doctors’ staff often fails to follow up on unpaid claims because they often lack the time to be persis- tent. By having a professional team of billing specialists at their disposal, doc- tors receive the most up to date information about the industry chal- lenges or changes. MedOfce also provides cycle management automa- tion to consistently maximize reimbursements, taking human error out of the equation. This allows for maximization of reimbursements every time. In some cases a doctor’s staff doesn’t pay enough attention to timely ling. This could be because staff members are preoccupied by other ofce tasks and duties. Because of such errors, doctors often don’t get paid or they don’t receive the right amount of reimbursement. In fact, the average doctor collects only between 50 to 60 percent of all the amounts that he or she bills out to insurers and patients. The rest simply goes uncollected. Because of this margin of error, a professional billing service can substantially increase a doctor’s “reimbursement ratio” (i.e., the dollar amount of claims submitted divided by the dollar amount of claims paid). Naturally, if a doctor discovers that the billing staff has been losing money, failing to process claims correctly, or not verifying that claims have been paid at the highest amount, he or she will be eager to hire a professional outside service.