Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, July 1, 1990 TAG: 9007010215
SECTION: VIRGINIA PAGE: D-3 EDITION: STATE
SOURCE: Associated Press
DATELINE: STAUNTON LENGTH: Medium
The New Hope couple opened Professional Health Claims in Staunton last month. It's a service that attempts to make sense of mountains of confusing insurance paperwork so that claims get filed and paid.
The concept is similar to that of a tax filing service, such as H&R Block.
Though there is no way to be certain, the Harrises think theirs is the first medical claims filing service in the state and one of about 30 similar services nationwide.
The novelty of their venture was underscored when they attempted to get a telephone business listing. The operator had no category for their company and ended up listing Professional Health Claims under Senior Services.
That was all right with the Harrises, who have geared their business toward retirees.
"Professional Health Claims' mission is to take the burden off retirees when it comes to filing their Medicare bills and make sure they get full benefits," said Harris.
"Our job is to be the advocate for the client. We serve others, too, but others work for companies that have personnel departments. When they become retirees, they are kicked out, and that's where we come in and pick up the slack."
There was no one to pick up the slack when Harris' 75-year-old uncle was stricken with Alzheimer's disease two years ago - not even Harris, himself, who owned a health insurance agency in Charlottesville. The Harrises continue to operate that firm, Harris & Associates, in conjunction with Professional Health Claims here.
The uncle and his wife had three children, all of whom had moved away. The couple lived in Richmond when the diagnosis was made.
"I realized the struggles [his wife] was having with the paperwork," Harris said. "And I began looking at the clients we were dealing with as somebody's uncle or father or mother or aunt. I started thinking: Why isn't there someone they could go to who would process all this and handle it all for them?"
The Harrises, both 31, became that someone.
"You have the stress of medical problems, and then you have these charges," Harris said. "In other words, right when a person is least able to deal with it - if you've just had a stroke, or a hip replacement or have been told you have cancer - we can nurse the bills along."
The Harrises say their specialty is knowing how and where to file each claim, whether it is with Medicare, a private carrier or a commercial group insurance plan. They promise to keep track of all claims until payment is made.
One of their clients had 13 medical providers pursuing her with a lot of bills, Harris said. She needed help simply organizing the mountain of forms needed for her to collect her benefits.
Another client needed help interpreting how to divide the Medicare check she had received between two doctors who had treated her.
"We're going to deal with problem cases," Harris said. "We're the office of last resort. We're not looking for simple cases; some people can handle that on their own."
There is an enrollment fee for Professional Health Claims to organize a client's paperwork and establish a personal file: $25 a person, $30 a couple or $35 a family.
After that, a customer pays a flat annual fee to have an unlimited number of insurance claims filed. The membership fees are $79 a person, $119 a couple or $159 a family.
by CNB