ClaimCare - Billing and Coding Solutions/Service Company

ClaimCare: Powering the Back-End Medical Billing Operations

Carl Mays II, President & CEO, ClaimCareCarl Mays II, President & CEO, ClaimCare
ClaimCare’s mission statement is “To collect the maximum revenue for your practice as fast as possible while helping to alleviate costs and hassle for your organization.” With ClaimCare’s up-front focus on customer care, it is their innovative back-end processes that attract the attention of healthcare organizations.

The recent thrust towards healthcare’s pay for performance model has significantly intensified the complexities of medical billing. Despite the advancements in technology, the healthcare ecosystem is still plagued by an overwhelming presence of siloed infrastructure, resulting in a lack of smooth teamwork.

Therefore, technology companies venturing into the medical spectrum often find themselves in troubled waters. A decade earlier, discussions around medical practice management systems centered on switching the software solution. However, with the introduction of electronic medical record (EMR) systems, there has been a tectonic shift in the landscape. With this shift, many doctors and medical practitioners complain the transparency they enjoyed previously has been hindered.

ClaimCare resolved this conundrum by developing strong back-end systems that leverage a unique mix of various technologies that can operate across multiple platforms, which eliminates data bottlenecks, enhances transparency, and improves quality of service. ClaimCare’s system-agnostic approach, gives them the ability to work with various systems without requiring special adaptations, allowing ClaimCare to incorporate scalability, transparency, and flexibility in their solutions portfolio. The 15-year-old firm acts as a partner with its clients, providing billing, coding, and collections that conform to a client’s specific needs.

ClaimCare’s core solutions are built around well-architected processes that are executed by a skilled and motivated workforce.

The solution has strict metrics at every checkpoint, ensuring the processes run seamlessly.

Carl Mays II, President and CEO of ClaimCare, says, “We are primarily a service provider that optimizes technology to devise smart solutions. Although we have our proprietary technology, we focus on providing outsourced medical billing services.” With his firm’s solutions, healthcare organizations can take the compliance and collections struggle head-on, averting violations and driving up revenue.

What makes ClaimCare’s services even more appealing is the flexibility offered. The firm doesn’t pressure its clients to change technology. Instead, ClaimCare can handle the medical billing operations on the client’s system. Clients attest this puts them at ease, enabling them to avoid the arduous task of management and implementation of medical billing systems.

ClaimCare also has turnkey analytics tools that quickly identify clients’ areas of opportunities and assist them to enhance their collections. And, importantly, ClaimCare houses a 100 percent U.S.-based workforce that understands the nitty-gritty of American medical operations and lends an empathetic ear while devising solutions to specific problems.

ClaimCare’s innovative approach has translated into numerous client success stories. One of ClaimCare’s clients, a large multi-specialty healthcare organization, struggled with collection and profitability challenges. ClaimCare deployed its solutions and was able to identify the organization’s sources of lost revenue. According to Mr. Mays, “The client did not require a change of systems or technology; instead, they needed to redesign their processes and execute their back-end operations effectively.” ClaimCare optimized the client’s existing technologies, re-architected the systems, and implemented metrics that measured and monitored the key steps in the process. ClaimCare took over the back-end medical billing process and increased the client’s collections per wRVU by 19 percent in six months.

Sprinting ahead in full steam, ClaimCare continues to refine their proprietary technology to suit the current trends in technology, allowing them to provide better services to their clientele. While a push towards expansion in other verticals is commonplace in the tech world, ClaimCare intends to remain focused on its core solutions. The firm envisions strengthening its offerings by incorporating newer technologies that stand the test of time.