Simplified Health Plans
Hospitals and Health CareUnited States2-10 Employees
Simplified Health Plans is a small independent consulting firm in the United States focused on the hospitals and health care sector. It assists consumers in gaining access to quality healthcare and navigating payment for services by advising on health coverage options across private insurance, foundations, free and charitable clinics, and public programs including Medicare and Medicaid. The firm also analyzes provider directories and formulary details to align plan selections with patient needs and counsels on plan quality, service, and financial stability. It assists with enrollment into ACA coverage and handles appeals and grievances as part of its advocacy. The organization negotiates fees and payment terms using Medicare's RBRVS and state Medicaid schedules, and works to resolve billing and coding issues and other payer-related challenges. It also negotiates with managed care companies to obtain authorization for needed services and to address hospital or physician fee and billing concerns.