Claims Support
Help with confusing or problematic claims
Understanding EOBs, disputing errors, and resolving claim issues
Why does claims support matter?
5.0 Google Reviews
Health insurance claims are confusing by design. EOBs are written in code. Charges don't match what you expected. Denials happen for reasons you don't understand. Weltrio provides human support to help employees navigate claims issues.
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See where your benefit plan is leaking
Find out what gaps exist — and what you can do without changing your plan.
We'll show you where money is leaking, risks are growing, and what you can fix within your current structure. No pressure to change brokers, carriers, or benefit design. Just clarity.
- Gap analysis based on your actual plan structure
- Clear findings you can share with your broker
- Recommendations that layer on — no disruption required
EOB Interpretation
Explanation of Benefits documents are hard to understand. We translate EOBs into plain language so employees know what they owe and why.
Dispute Support
When claims are processed incorrectly, we help identify the problem and dispute it with insurers. Many errors are correctable with proper documentation.
Denial Investigation
Claim denials often seem arbitrary. We investigate denials to understand why they happened and whether they can be appealed.
Payment Verification
When bills arrive, we help verify that amounts match what should be owed based on insurance processing. Billing errors are common and often favor providers.
What is Claims Support?
Claims Support helps employees navigate the health insurance claims process—understanding what they owe, identifying errors, and resolving problems.
Every healthcare service generates a claim. Insurance processes the claim and sends an EOB. Providers send bills. When everything works, employees pay their portion and move on. When things go wrong—and they often do—employees face confusing paperwork and frustrating phone calls.
Claims support provides expert help navigating these situations, ensuring employees understand their obligations and don't pay more than they should.
Why Do Claims Create So Many Problems?
Most employers renew their health plans year after year without questioning the underlying assumptions. Brokers present options, carriers set rates, and leadership approves budgets based on incomplete information.
The result? Companies overpay for benefits employees don't use while missing coverage gaps that create real risk. They accept premium increases as inevitable rather than addressable. They lack visibility into where their money actually goes.
A Healthcare Risk Assessment changes that. It gives you the data and insight to make informed decisions, negotiate from a position of strength, and take control of one of your largest operating expenses.
How It Works
Claims support provides assistance with any claims-related issue.
Issue Intake
Employee contacts Weltrio with a claims concern—confusing EOB, unexpected bill, denial notice, or any other claims-related issue.
Investigation
We investigate the issue—reviewing EOBs, comparing to bills, examining claims processing, and identifying what went wrong.
Action
Based on investigation, we take appropriate action—explaining correct obligations, disputing errors, appealing denials, or coordinating with providers.
Resolution
We work the issue to resolution, communicating outcomes and ensuring the employee understands their actual obligation.
When Should Employees Request Claims Support?
Employees should request support when:
• They receive an EOB they don't understand
• A bill seems higher than expected
• Insurance denies a claim unexpectedly
• Bills don't match EOBs
• They're not sure how much they actually owe
• Collection notices arrive for disputed amounts
• Any claims situation creates confusion or concern
Where Does Claims Support Apply?
Claims support applies to all health insurance claims:
• Hospital claims (inpatient and outpatient)
• Physician office claims
• Lab and imaging claims
• Pharmacy claims (when applicable)
• Any claim processed through health insurance
Who Benefits from Claims Support?
Any employee with health insurance benefits:
• Those receiving confusing EOBs
• Employees with unexpected or disputed bills
• Anyone whose claims have been denied
• People who've received collection notices for medical bills
• Those who want help understanding what they owe
See What Our Customers Are Saying
"What could have been data driven, was soon a conversation. Over 3 years with the best coaches, listeners, advisors you could ask for. If Monique didn't have an answer readily, she would note it, research it, and then update you on the answer. Always a positive meeting. Highly recommend!"
— Sue D.
“Our Medical Insurance Premiums were Out of Control! Thanks to Weltrio and their amazing team of healthcare experts, Weltrio is my single most-profitable cost center!”
— Cayuse CEO
Everything You Need to Know
At Weltrio, we are a medically trained team that works with HR and benefits partners at companies of all sizes to improve healthcare quality, reduce risk exposure, and optimize costs. We work within your existing plan structure—providing employers with clarity, trust, and transparency at every step. Whether you're upgrading your benefits plan or building from scratch, we've got you covered.
Is this the same as telemedicine?
No. Clinical support provides guidance and triage, not diagnosis or treatment. We help employees decide when and where to seek care.How many nurses will be assigned to our company?
Assignment depends on your company size and typical utilization. Smaller companies may share a primary nurse with backup coverage. Larger organizations get dedicated teams. Either way, employees experience consistent relationships with clinical professionals who know them.Who answers calls in the middle of the night?
Board-certified nurses from your Weltrio clinical team. We staff night shifts with experienced nurses who have full access to your company's benefits information and employee interaction history. It's not an outsourced answering service.What protocols do nurses use for triage?
Our nurses use evidence-based clinical decision support protocols developed from emergency medicine and primary care best practices. These protocols are regularly updated based on current medical guidelines and are customized for telephone/virtual assessment settings.How much does an unnecessary ER visit actually cost?
Average ER visits cost $2,200 or more—even for minor issues. Add lab work, imaging, or specialist consultation and costs climb quickly. The same conditions treated at urgent care typically cost $150-300, and telehealth visits run $50-75.
