CLAIM WATCHER®
A different kind of health plan
Traditional health plans hide the true cost of care while premiums keep climbing. Claim Watcher takes a different approach, one that values transparency and affordability, without compromising care.
- self-funded employers
- groups with 100+ employees
Available nationwide
HOW IT WORKS
1.
Open access with no network restrictions
Claim Watcher plans offer flexible access to care without traditional network restrictions. Through our Clear the Path™ approach, members can work directly with the providers they choose — helping reduce unnecessary costs often built into conventional network contracts.
2.
Proactive outreach before care begins
Our Provider Relations team works directly with hospitals and providers before appointments take place. By coordinating early and setting expectations upfront, we help create a smoother experience for both members and providers.
3.
Nationwide access with familiar providers
Members have access to a broad nationwide network of 600,000+ physicians, specialists, and ancillary providers for everyday care. This approach maintains provider choice while focusing cost management where healthcare spending is highest — facility-based services.
4.
Transparent auditing and fair repricing
Every claim is reviewed using a transparent reference-based pricing methodology designed to identify fair reimbursement levels. Supported by extensive claims data and provider negotiation expertise, the process delivers consistent and defensible outcomes.
5.
Dedicated support at every step
Members receive ongoing support through a combination of personal guidance, digital tools, and proactive education. Our Concierge Member Services team helps members understand coverage, navigate care, and resolve questions with confidence.
6.
Protection when it matters most
Balance bills are uncommon due to proactive provider engagement and pre-service negotiation efforts. If an issue does arise, Claim Watcher provides hands-on advocacy and end-to-end support to help protect both members and plans.
WHO IT’S FOR
For employers balancing purpose and cost
Claim Watcher® is designed for employers who care deeply about their people, helping mission-driven organizations sustain quality, affordable coverage for their employees.
Nonprofits
- Human services, long-term care, and IDD providers
- Behavioral health and community care organizations
- Faith-based or mission-driven organizations serving local communities
Privately Owned
- Construction and specialty contracting businesses
- Manufacturing and industrial companies
- Retail and multi-location service employers
- Transportation, logistics, and distribution companies
Public Sector
- Municipal and local government agencies
- Public school systems and educational institutions
- Public utility and community service organizations
Real claims. Real savings.
Flexible plan structures to fit your goals
RBP + Physician-Only Network
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Combines familiar access with greater control over high-cost claims.
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Primary Care: Members have access to Prime Health’s extensive physician only network with over 600,000 primary care providers across the U.S.
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Hospital and Facility claims are repriced with RBP with balance bill protection.
Dual-option arrangements are also available.
Talk to your Homestead representative to learn more.
RBP + Direct Primary Care (DPC)
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Enhances care access through unlimited primary care visits, same-day or next-day appointments, and virtual options.
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Improves health outcomes and reduces downstream costs by fostering stronger patient-provider relationships and early intervention.
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Ideal for employers focused on prevention and creating a personalized healthcare experience for day-to-day care, while targeting high-cost hospital claims and reducing long-term spend.
Dual-option arrangements are also available.
Talk to your Homestead representative to learn more.
RBP Only (Full Replacement)
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Delivers the greatest savings potential and simplicity.
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Ideal for employers with appetite for driving meaningful change and committed to employee communication and engagement.
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Supported by Homestead’s full member advocacy and provider support team.
Dual-option arrangements are also available.
Talk to your Homestead representative to learn more.
Having the right support makes all the difference
Clear the Path™
Our Clear the Path™ program makes your transition to Homestead simple – ensuring employees are all set to see their providers – when the plan starts.
Concierge Member Services
Our concierge member services and provider relations teams work with your organization during onboarding, contacting your member’s providers to introduce Claim Watcher® and get them comfortable with reference-based pricing. Our Concierge Member Services team educates and assists members making the best choices for their health care needs.
Balance Bill Protection
Because we introduce the plan to providers before members seek care, balance bills are rare. But if a member does get a balance bill, we’ve got their back. We provide full legal defense and ongoing member advocacy – and manage the process from start to finish – at no additional cost to the member or the plan.
FAQs
Frequently asked questions
How is Claim Watcher different from other reference-based pricing solutions?
Many standalone RBP solutions are built primarily to reprice claims, not to manage the full healthcare experience. Without comprehensive provider engagement and member support, their ability to deliver smooth access to care and a positive employee experience is inherently limited. Claim Watcher is different.
Homestead combines transparent RBP pricing with integrated plan administration, proactive provider outreach, Concierge Member Services, and stop loss solutions in one coordinated model designed to support both savings and a more connected, supported healthcare experience.
How much can we realistically expect to save with a Claim Watcher plan?
Savings will vary based on your current plan design, claims experience, employee population, and other factors. However, host employers see meaningful reductions in overall healthcare spend compared to traditional PPO plans — often in the range of 25–30%.
Can Claim Watcher work with our current partners or other benefit solutions?
Claim Watcher is very flexible and successfully integrates into many existing employer benefits ecosystems, Rather than forcing a one-size-fits-all approach, our team works closely with brokers and employers to evaluate, identify what’s working well, and build a right-sized strategy that supports savings, access to care, and a strong member experience with minimal disruption.
Have more questions?
