Finally.

A Claims Review Service That Actually Works.

We Call It Claims Insurance.

You Call It Peace of Mind.

FOR BUSINESS MANAGEMENT

Remove Claims Review Liability

From Your Firm

FOR YOUR EMPLOYEES

Claims Help When They

Need It the most.

1 OUT OF EVERY 5 MEDICAL CLAIMS

ARE PROCESSED INCORRECTLY

That could mean a significant impact on your finances, your insurance plan or even your health if it prevents you from seeking further treatment. Let Cofactor review your claims, ensure they are correct and even negotiate down any amount you might owe to an out of network provider.

THE COFACTOR SOLUTION

Powered by Claims Advocacy Experts and integrated algorithms, Cofactor provides a fully HIPAA compliant platform to upload and review the status of your claims. Whether for your business management clients or your employees, let Cofactor remove the confusion and errors with your insurance today.

BACKED BY QUANTUM

Our cutting edge claims review service is backed by Quantum’s years as a leading employee benefits firm. We have won numerous awards for our service, but more importantly, we ensure that your company has the highest level of guidance and support for its benefit plan.

Let Cofactor handle the claims review and advocacy for your firm, removing the liability to the company.

Cofactor covers your employees should they have any problems with their claims. Surgeries, deliveries, or just verifying the annual physical should have been free, our claims advocates will remove the stress and ensure the claim is handled properly.

COFACTOR FEATURES

CLAIMS ACCURACY

Much like financial accounting, medical coding and reimbursement has a complex set of rules that can lead to varied interpretations, and unintentional oversights. Medical providers bill claims to maximize revenue. Third party administrators and insurance carrier process claims efficiently, but incur additional costs or risk abrading providers when they stop payment. So mistakes and overpayments happen. Cofactor utilizes a proprietary set of algorithms to identify errors and oversights and make sure you don’t end up paying for them.

INSURANCE PAYMENT CONFIRMATION

20% of all claims processed by insurance carriers are incorrect. The errors could rest with the claims processor or the provider’s office. We first ensure the medical codes are accurate, then we verify the claim was paid per the benefits of the claimant’s plan. Once we confirm everything is accurate we let you know the status.

OUT OF NETWORK CHARGES NEGOTIATION

Whether on purpose or accident, sometimes the insured finds they went to an out of network provider. If your insurance covered the claim at all depends on your benefits. However, even if it is covered, the out of network provider can balance bill you – or charge you anything they want for their services. Cofactor steps in and negotiates down in remaining balance due. Our deep knowledge of insurance allows us to determine a fair price and often when paying a claim yourself, providers allow deep discounts.

FULLY HIPAA COMPLIANT SERVERS

Client privacy is not only paramount when dealing with Private Health Information (PHI), it’s the law. We are the only claims advocacy service offering true HIPAA compliance security from start to finish. We deal with some of the biggest names in the world, and we take the protection of their information seriously.

SECURE AND HIPAA COMPLIANT PORTAL ACCESS

In addition to our HIPAA compliant servers, we also have the highest level of security on our portal. From start to finish feel confident that your information is safe with us.

EXPERT SUPPORT FROM CLAIMS ADVOCATES

While we utilize advanced algorithms to execute our claims advocacy, behind each and every claim is an expert Certified Claims Auditor. Our advocates are trained in the fine art of persistence when working on claims. They deal directly with the provider’s office to obtain information and confirm claims were submitted correctly. They also spend extra time explaining everything so that you know what actually is going on with your claims.

© 2019 Quantum Insurance Services