Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, July 22, 1990 TAG: 9007200089
SECTION: BUSINESS PAGE: D-9 EDITION: METRO
SOURCE: STACEY CHASE RICHMOND TIMES-DISPATCH
DATELINE: STAUNTON (AP) LENGTH: Medium
The New Hope couple opened Professional Health Claims in Staunton in June. It's a service that attempts to make sense of mountains of confusing insurance paper work 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 tried to get a telephone business listing. The operator had no category for their company and ended by 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 that 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.
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 paper work," 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.
Harris maintained that he and his wife operate not only a medical-claims filing service, but also act as personal-claims consultants to their clients.
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. Still others needed someone to help them work out payment plans with their creditors.
"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. We're looking for people who need our support."
There is an enrollment fee for Professional Health Claims to organize a client's paper work 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.
Harris said the membership fee covers everything for the year, and there are no additional charges for services related to satisfying a claim, such as phone use and postage.
Harris concedes that his is a business that offers convenience. But so are many successful business ventures, such as McDonald's.
"How many people would die tomorrow if McDonald's closed up?" Harris said. "Probably no one. It's the same thing. We're banking on the fact that the insurance claims hassle factor will encourage people to use us."
by CNB