Billing & Claims

Alyssa Fikaris works in our billing & claims department

Billing Versatility

Selman & Company is able to maintain the billing experience to which members or customers are accustomed. We can create timing rules within our administrative system that are flexible and customizable. If needed, additional modes and methods are available, including EFT/ACH/PAC, which can improve customer experience and therefore, drive retention.

Premium Rates

The versatility of our administrative system allows us to calculate premium rates in virtually any conceivable way including, but not limited to:

  • level premium rates
  • composite rates
  • age banded rates
  • smoker/non-smoker rates
  • primary/spouse/family rates
  • state
  • zip code rates
  • rates based on the older age of primary insured or spouse
  • gender-based rating
  • unit rating

We also have the option to include modal factors, policies, and billing fees that may vary by billing method and mode. We can do this within the premium or shown separately from premium on direct-billed premium notices.

Billing Methods

Available Methods: 

Direct Bill | EFT/ACH/PAC | Credit Card | List Bill/Payroll Deduction | Self-Administered Bill

Available Modes:

Monthly | Quarterly | Semi-Annual | Annual | Semi-Monthly | Weekly

For all of our billing methods (Direct Bill, EFT/ACH/PAC, Credit Card, List Bill (payroll deduction), and self-administered bill) the timing rules that are set within the administrative system are flexible and customizable. 

Integrated Claims

We understand that timely and quality claims handling is the true foundation of any insurance offering. We have extensive experience in providing claim services for a wide variety of life and health insurance programs.

  • Fully integrated billing, administrative and claim payment system
  • Processing control including authority limits at both aggregate and adjuster levels
  • Audit rules based on payment amount and volume
  • Comprehensive workflow management and imaging for paperless processing
  • Comprehensive reporting and analysis to manage and monitor utilization and trends

Insurance Claims Processing

Selman & Company can perform both functions: claims adjudication or claims certification. Our claim processing unit can be segregated into claims that are processed, prepared and certified by Selman and Company but forwarded to the insurance company for payment and those that are fully processed, prepared and paid by our staff.

Our claim system is fully integrated with the administrative system, but it has the flexibility to be configured to process claims where the policy is not billed and administered within the system. This can be accomplished through regular data feeds of critical data required to adjudicate claims or through integration using a web service. Our system is well positioned to process Accident, Term and Whole Life, Cancer, Critical Illness, Hospital Income and Accident, Disability, Return of Premium and Medical Supplement, Long Term Care, among others. Integrating with the administrative system also provides an efficient mechanism to check for multiple policies upon notification of death and calculation of return of premium (assuming history is available to convert).

Learn more about claims capabilities in depth: 

Four Best Practices for Insurance Claims Processing

5 Secrets to Improve the Insurance Claims Call Center Experience

 

Reduce the cost of claims and billing. Inquire today.

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