Paradigm Claim Services
We are an advocacy group for people
with long term care insurance policies
We manage claims nationwide for seniors
and for the companies who provide them with care.
Paradigm
Claim Services
We are an advocacy group for people with long term care insurance policies
We manage claims nationwide for seniors
and for the companies who provide them with care.
are you a Care Provider Company?
are you a Care
Provider Company?
LONG-TERM CARE
INSURANCE IS DIFFICULT TO UNDERSTAND
For seniors, getting older and recognizing they are no longer able to fully manage their care needs is a harrowing realization. For many others, the lack of insight into their declining state puts them at risk for greater harm. Underscoring these issues is how seniors will ultimately fund their care needs.
For these reasons, advocacy is crucial. Advocacy begins with education and ends with the execution of a professionally and thoroughly crafted life care plan. We stand behind and advocate for our customers, regardless of where they stand on this journey towards receiving long term care.


PARADIGM ADVOCACY NETWORK
MEMBERSHIP SERVICES FOR SENIORS WITH POLICIES
The Paradigm Advocacy Network (PAN) is a subscription based service designed to provide you with the most cost effective way of understanding and planning for your long-term care needs. By subscribing to this service, Paradigm’s team of experts will review your policy benefits; meet with you in person or on the phone to make sure you understand your benefits; work with you to understand and select the most appropriate care setting for your needs; help you select the highest quality care providers in the industry; help you activate your policy benefits; and monitor your claim.


ADVOCACY
HERE'S WHAT WE DO FOR OUR SENIOR MEMBERS
Six Wellness
Calls a Year
Periodic phone calls to check on your well-being. These calls are meant to ensure you are completely satisfied with the care and services you are receiving or to gauge readiness for care and placement.
Referral Advocacy
and Placement Handling
Paradigm will handle the entire process of placement and referral for home care or assisted living. This ensures that you can start receiving top quality care as quickly and smoothly as possible.
Policy Balance
Calculator
You can keep track of your remaining benefits on your policies as well as VA and Medicaid Authorizations.
Consultation with a Paradigm affiliated law firm
If you desire a legal consultation, you can easily be referred to a Paradigm affiliated law firm for consultation and assistance at a discounted rate.
Virtual Safe
Deposit Box
You can store your POA’s, Advance Directives, Assessments, Invoices, Plans of Care, medical records, and other critical documents related to your long term care planning and health.
One 60 minute
Consultation
A 60-minute consultation, policy review, and a full explanation of the claim process. This can be accomplished either at your home, the resource center, or via video call.
Nurse Assessment for Care Needs and Eligibility for Policy Benefits
In order to open an LTCI claim with an insurance company, a nurse must assess your condition and articulate your needs in a detailed report. Paradigm will have a qualified licensed healthcare practitioner provide you with this service. The assessment will establish your baseline of functioning and determine the need for assistance with your ADLs (activities of daily living), and any durable equipment and/or home modifications. This assessment is the first and most critical step in advocacy and policy activation.
Paradigm Claim Handling
and Management
This includes:
  • The preparation and submission of the claim to the payer
  • Guaranteed claim payments to the provider
  • Tracking claim payments
  • Claim monitoring
  • Handling escalations
  • Transitioning to different care settings


ADVOCACY
HERE'S WHAT WE DO FOR OUR
SENIOR MEMBERS

ARE YOU A CARE PROVIDER COMPANY?
BECOME PART OF THE PARADIGM NETWORK
ARE YOU A CARE
PROVIDER COMPANY?
BECOME PART
OF THE PARADIGM NETWORK
SENIOR ADVOCACY MEETS BILLING ACCURACY
Paradigm is the only company in the market that has been able to create a full (patent-pending) back-office solution to adequately deal with the nuances inherent in LTC policies. Paradigm’s collection record in terms of speed and success is unparalleled.
Our passion for senior advocacy has inspired us to create something truly unprecedented. By lightening the bureaucratic load of provider companies, we can ensure that their main focus is the wellbeing of their clients. Thus, we have built a comprehensive platform that simplifies the entire LTCI claims and billing process.
In short: We take the uncertainty out of submitting claims. We get the claims paid fully, and on-time.


WANT TO KNOW MORE?
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