ClaimDOC

06/02/2026

As we head into these hot summer months, we’re excited to celebrate this group that brings the heat every day. We’re proud to have them on the team!

06/01/2026

We closed out the month of May with a little mini-golf competition and, in true ClaimDOC fashion, the winner couldn’t be decided without a tiebreaker. After plenty of laughs and a few clutch shots, we officially crowned our top teams.

1st place: Alexis Velez, Fallon Heater, Ryan Beckett and Robin Saxon
2nd place: Donna Edge, Katie Heggen and Tristen Cummings.

Thanks to everyone who joined in and made it a fun one.

05/29/2026

The relationship between healthcare providers and payers has gotten so incredibly complicated. But how did we get here?

In the latest episode of ClaimTalk, our in-house experts Ben Krambeck, Brad Hansen and Cynthia Swanson join Danielle Young to explore how legislation, regulatory decisions and industry dynamics shaped the current state of the health insurance industry. Going back to the early '80s, they discuss how technological advancements, coding requirements, physician group ownership structures and misguided quality assessments played a role in driving up costs for the working American.

Their conversation takes a closer look at the history behind the system — and why understanding that history can help everybody make smarter decisions moving forward.

  Purchasing healthcare didn’t become this complicated overnight. So how did we get here? Our industry experts — CEO Ben Krambeck, Vice President of Provider Relations Brad Hansen and Vice President of Audit Services Cynthia Swanson — join ...

05/28/2026

Freestanding emergency departments are showing up more often in claims — at a significant cost to health plans. In her latest Audit Spotlight, Cynthia Swanson shares how our audit team identified excessive physician and facility charges at an FSED and helped the plan avoid more than $74,000 in unnecessary healthcare spend.



Read her article below.

Freestanding emergency departments (FSEDs) have evolved from a niche access point in healthcare to a fast-growing sector. They operate in at least 32 states and saw a 75% growth rate ahead of the pandemic. Today, high concentrations of ...

05/27/2026

Thank you to everyone who joined ClaimDOC at Carb Day at the Indianapolis Motor Speedway last weekend! It was a great opportunity to connect in the Arrow McLaren suite over food, drinks and conversation, with an incredible view of all the action on the track.

The day included pit and garage access, tours, the Wienie 500, and a concert featuring Counting Crows and Switchfoot — making for a memorable experience on and off the speedway.

05/25/2026

Today, we honor the brave men and women who have given their lives for this country. Their sacrifice will never be forgotten.

05/22/2026

How the heck did the healthcare industry get here?

Our industry experts — Ben Krambeck, Brad Hansen and Cynthia Swanson — join Danielle Young on the next ClaimTalk to take us back to simpler times, pre-Affordable Care Act, and through all the changes that bring us to today. They deconstruct the complexities of claim reimbursement, coding and billing; explain why they’re hard to navigate; and detail the challenges they pose for brokers, employers and members alike.

05/21/2026

A Florida public school district just reaffirmed how reference-based pricing helps plan sponsors regain control of healthcare costs.

Flagler Schools was facing a 22% renewal hike this year, while its insurance fund was already $800,000 in the red. The district couldn’t sustain another increase.

So, Flagler reimagined its health plan with help from their broker and ClaimDOC. The district joins several other public entities nationwide that have moved away from their traditional plans. The result: the district will offer teachers and staff a plan with no increase in employee contributions while reducing the cost of dependent child coverage by 56%.

As one school board member put it, “Health care as we know it is broken, but here’s cause for celebration. You'd be hard pressed to find any other organization in this environment not drastically increasing their cost of premiums.”

Read more about the board’s decision below.

Because of high claims this school year, the district's insurance fund is $800,000 in the red.

05/11/2026

It's not uncommon for providers to have questions about reference-based pricing plans. That’s why strong member advocacy matters.

When one provider required a member to pay $200 upfront and refused to contact us, she ended up overpaying by $162. With Bridget's help, that member secured a full refund.

By preventing unnecessary costs, we help protect both the member experience and the value of the health plan. While $162 may seem small in the context of overall healthcare spend, our member advocates know every dollar matters.

05/07/2026

Today, we’re celebrating AAPI Heritage Month with a catered lunch from Teriyaki Madness! It’s a small but meaningful way to recognize and appreciate the rich cultures, contributions and perspectives of Asian American and Pacific Islander communities.

As a company that values diversity, we’re grateful for any chance to celebrate the people and traditions that help shape our communities and our workplace.