Claim Counselors

Kunkel & Associates Claim Counseling program is designed to relieve the time constraints for employers and employees by assisting in health plan-related issues.

Claim Counselors will aid employees in understanding the health plan operations including:

Deductibles
Co-payments
Coinsurance
OOP Maximums
Claim Filing Requirements
Extension of Benefits
Flexible Spending

Exclusions
Limitations
COB
Requests for Information
Appeal Process
Eligibility
HSA/HRA

Claim Counselors will also investigate claims payment and/or eligibility accuracy and act as an intermediary between employee and administrator as needed.

Program advantages to the employer include:

Save time and resources
Assist with HIPAA Privacy issues
Better track PPO service gaps to ensure claim stays in-network
Direct potentially large claimants to Case Management
Track and correct billing errors
Track and correct claims payment errors
Capture fraudulent claims