ClaimTalk

ClaimDOC
  • 5.0 (6)
  • BUSINESS
  • UPDATED MONTHLY

Welcome to ClaimTalk, the official ClaimDOC podcast, where we dive deep into the complex world of unbundled health plans. Together with industry experts, we'll pull back the curtain on a wide variety of cost containment topics. We'll provide listeners with a lot of information with a few shenanigans along the way. 

  1. JAN 29

    The Search for a Good TPA — Part 2 | Ep. 21

    Selecting the right vendors for a reference-based pricing health plan isn’t an exact science. At the end of the day, it often comes down to experience, discernment, and the ability to read the signals vendors give off long before the contract is signed. In this episode of ClaimTalk, Emma Fox, CHVA joins Danielle Young, Bruce Hansen and Stephanie Mohr to continue their unapologetically candid examination of vendor dynamics to offer pointed insights on evaluating partners that can make or break a self-funded strategy. They break down what truly constitutes “good” and “bad” vendor vibes, define what real competency actually looks like, and outline how to identify red flags before they turn into costly mistakes. If you’re serious about elevating your self-funded health plan performance, this conversation cuts through the noise and shows you what to look for, because not every vendor deserves a seat at your table.

    40 min

  2. 12/12/2025

    The Search for a Good TPA — Part 1 | Ep. 20

    Building a successful self-funded health plan demands skilled and efficient vendor partners that have the expertise to deliver on their promises. Identifying the best vendors can be challenging, and settling for substandard partners can lead to less-than-desirable outcomes. But how do you find the best partners? On this episode of ClaimTalk, Emma Fox, CHVA gets brutally honest during the first half of a two-part conversation with Danielle Young, Bruce Hansen and Stephanie Mohr on the struggles that can arise with vendors. While a good portion of the discussion centers on the issues they've experienced with third-party administrators, they also discuss why it can be difficult to find the right partners, the strategies they use to identify dependable vendors, and why some of the most unreliable vendors continue to survive in the industry.

    38 min

  3. 10/23/2025

    Why RBP Success Starts With HR | Ep. 19

    In 2022, Featherlite Trailers partnered with ClaimDOC to begin implementing a new reference-based pricing health plan for its employees. It's no secret that moving to an RBP plan can come with friction but, with Shannon Westin, SHRM-SCP leading its human resources department, Featherlite didn't just endure the change, they owned it.  Westin joins Danielle Young and Amy Hansen on ClaimTalk this month to share how taking the time to truly understand the plan and being proactive in resolving potential issues caused watercooler talk to shift from uncertainty to appreciation.

    31 min

  4. 09/19/2025

    Vetting Your Vendors' Cyber Vulnerability | Ep. 18

    If your organization sponsors a self-funded health plan and cybersecurity isn’t part of your vendor evaluation criteria, it’s time to reassess. Protecting your own infrastructure is essential, but it’s not enough. Every vendor with access to your data must meet rigorous cybersecurity standards. Otherwise, you're not just accepting risk, you're creating it. In this episode of ClaimTalk, Andrew Smith and Jeremy Schuller share with Danielle Young some of the threat tactics that cybercriminals are using today and discuss best practices in evaluating vendors to ensure your data will be secure.

    40 min

  5. 08/29/2025

    Making Sense of Cash Pay | Ep. 17

    Paying cash for healthcare services is not a new concept, but it's also an option that is not widely used. The reason for that is because many providers prefer to accept reimbursement from insurance. But cash pay does have its advantages. On this episode of ClaimTalk, Danielle Young visits with Amy Pellegrin and Leah DeBartolo about the pros and cons of cash pay, how health plans can create service around cash pay, and what stands in the way of cash becoming a more popular payment option for healthcare.

    44 min

  6. 07/17/2025

    Adapt or Fall Behind: Making Nontraditional Plans Thrive | Ep. 16

    For nontraditional health plans to work — whether they use reference-based pricing or another strategy — they often require customized solutions. As health plans evolve, vendors can't ignore new methods to give plan members what they need. In this episode of ClaimTalk, Amy Pellegrin and Stephanie Mohr visit with Sharla Mallett, a member of our direct primary care team. They discuss how the DPC team works to give members a more personalized health plan experience and why making adjustments to health plans is crucial to providing a positive member experience.

    23 min

  7. 06/20/2025

    Direct Contracts & Healthcare Pricing Complexities – Part 2 | Ep. 15

    Whether you're using a reference-based pricing strategy or some other alternative, there are many challenges in creating an effective direct contract. Much of the time, they boil down to the complexities of healthcare pricing in one way or another. Whether it's compliance with regulations, plan design or services billed by a third party, creating an effective direct contract requires a partner with the expertise to help you maneuver through all elements of the agreement. This month, Jay Kempton, Shane Cerone and Brad Hansen return to ClaimTalk for the second half of an in-depth discussion on direct contracts and how to navigate inconsistencies in healthcare pricing.

    32 min

  8. 05/22/2025

    Direct Contracts & Healthcare Pricing Complexities – Part 1 | Ep. 14

    Healthcare access can be the biggest hurdle to successfully implementing a reference-based pricing plan. Sometimes it requires creating an agreement called a direct contract between a health plan and a provider to ensure access to that provider. Direct contracts are an effective tool for RBP health plans, but they can be more complicated than they sound.  On this month's ClaimTalk, experts Jay Kempton, Shane Cerone and Brad Hansen discuss the complexities of direct contracts and their impact on the rising cost of healthcare.

    30 min
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Trailers

Ratings & Reviews

5
out of 5
6 Ratings

About

Welcome to ClaimTalk, the official ClaimDOC podcast, where we dive deep into the complex world of unbundled health plans. Together with industry experts, we'll pull back the curtain on a wide variety of cost containment topics. We'll provide listeners with a lot of information with a few shenanigans along the way. 

Information

  • Creator
    ClaimDOC
  • Years Active
    2024 - 2026
  • Episodes
    23
  • Rating
    Clean
  • Copyright
    © 2026 ClaimTalk
  • Show Website
    ClaimTalk

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