Disability Claims Solutions, Inc. provides insureds across the USA with resources to make better decisions concerning ERISA Group STD/LTD claims, as well as Individual Disability Income benefits and Long-Term Care. Having the opportunity to work with an expert consultant, such as Linda Nee, provides insureds with valuable procedural options to work through problematic issues in successful ways.
Our focus is to resolve problems, not wrestle with conflict. Call Linda Today!

Disability Claims Solutions

Disability Claims Solutions, Inc. provides insureds across the USA with resources to make better decisions concerning ERISA Group STD/LTD claims, as well as Individual Disability Income benefits and Long-Term Care. Having the opportunity to work with an expert consultant, such as Linda Nee, provides insureds with valuable procedural options to work through problematic issues in successful ways.
Our focus is to resolve problems, not wrestle with conflict. Call Linda Today!

Beware of Insurance Paper Chasing

 

I’m sure that at one time for another every insured as been frustrated by insurance paper chasing. The insurance industry is infamous for its focus on what it refers to as “forms”, some of which is mandated and required by state regulators, and the remainder generated by insurers.

In fact, the industry itself has become so burdened with useless paperwork, that claims handlers have long since lost the capacity to request, review and maintain control over “paperwork.” As a result, all insurers now pay for the services of “third party paper chasers” who, in the end, further complicate an already impossible focus on generating paper to prove disability claims.

First, third party paper chasers harass, intimidate and often threaten physicians’ offices for information. Perhaps it is a good idea to remind readers that physicians have no obligation to provide patient notes, or return forms – it isn’t their their job. When physicians are called everyday about sending paperwork, your future as a patient becomes more and more at risk.

Second, paper chasers are never given any training about what Plans and policies say about time restrictions on providing proof of claims. Most of the chasers I am acquainted with give physicians “short deadlines” such as 10 days to provide requested paperwork, which is grossly “out-of-contract. A 10-day requirement makes physicians very nervous indeed.”

Third, paper chasers are highly inefficient and often lose, misplace, and not provide claims handlers with paperwork at all. This places the insurance company in a position of sending out “We didn’t get it!” letters that in turn scares the heck out of insureds. Hiring the paper chasers clearly hasn’t done insurance companies any favors.

Lastly, paper chasers always operate within their own chaotic protocols. For example, one chaser demands that separate authorizations be signed for each physician. One of my clients was asked to sign as many as 10 Authorizations for 10 doctors. When I called to ask them if it wouldn’t be easier to list all ten physicians on one Authorization, I was told they had to do it the way the company told them to.

In fact, on more than one occasion I’ve had to ask claims handlers to have their chasers “stand down” for many different reasons. Therefore, a system that was at first seen as “better” has turned out to be more negligent than ever before.

The solution is for insureds to request and send their own paperwork directly to insurers, but that can also become costly and disorganized as well. Insurance companies would never dare to admit it, but the problem of requesting patient notes was a great deal more efficient when claims handler’s themselves made the requests and were accountable for their own follow-up. As I’ve said, however, the claims review process changed and remote handlers working from home, generally do not have access to resources to do their own paper chasing as they once did.

Unfortunately, paper chasers are here to stay, but insureds and their reps need to intervene when paperwork isn’t getting where it needs to be. It’s OK to ask claims handlers to have their agents stand down. It’s also important to hold insurers to the “proof of claim” time limits outlined in your policy or Plan.

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