Consider the voluminous amounts of paperwork that goes “in” and “out” of an insurance company for just a moment. In fact, insurance is one of the top five “paper” laden industries there is.
Therefore, it is absolutely necessary for insurance companies to be able to handle literally millions of pieces of paper every day. This is not something claims handlers have time to do, and it would be impossible for just a few people to scan all of the paper in, or process all the letters, and checks, going out.
The process of “paper” in an insurance company is handled by a specialized part of the company called a Communications Center. These “centers” employ hundreds of people who open, scan, and send information to data files and desktops. Claims handlers DO NOT write their own letters, but choose templates from their desktops they can tweak to make them seem personally written. In many cases, claims handlers do not even sign their own letters.
Although insureds may understand the concept of centralized communication, they often forget that processing paper takes time. In the average insurance company, it often requires several days for patient records, for example, to be scanned and uploaded so that claims handlers can have access. All paperwork is initially entered in a data base, identified by your claims number. Then it may take another 1-2 days for the claims handlers to do something with it, and then 2-3 weeks to have it reviewed by internal resources.
Therefore, when insureds begin their own chase for “verification of receipt” a day or so after, or complain they didn’t get a “verification”, it is possible, and quite likely, that the information was not scanned and sent on its way. Although insureds tend to want their information “verified” immediately, communications centers aren’t set up to do that and the systems in place nearly always fail to “verify” receipt, or at least verify it quickly.
You would probably be surprised to learn how many insureds try to comply with “deadlines” that are on the weekend. Deadlines are determined either by a computer, or claims handlers who fail to look at a calendar, however, update paperwork IS NOT DUE ON A WEEKEND. In fact, insurance employees are infamous for clearing out on Fridays at about 1pm, and there is usually only 1 person left until 5pm to answer internal calls. If you’ve ever tried to contact an insurance company after 1pm on Friday, you know what I mean. If you send in your paperwork on a weekend, there is no one there to process it until the following Monday.
Insureds most always think that letters to them are sent by the claims handlers, which is not true at all. Claims handlers initiate letters from drop down windows on their computer. Then, an admin forwards the letters to a local mail center, then the letters are sent to the centralized Communications Centers for actual posting. Isn’t it any wonder when insureds receive letters dated two weeks prior to when they receive them?
Most insureds have higher expectations of insurance communications than what they really get, but all the chasing for “verification of receipt” is often left to deaf ears. What makes matters worse, is that insurance companies are so inefficient to begin with they send out letters documenting “information was not received”, upsetting insureds, when the Communications Center hasn’t even scanned the received information in yet. If you contact them a day or two later you will be told, “Oh yes, we did receive that information.” Insureds get worried and anxious when it’s really a time fluke in the system that’s not going to change. Communication Centers will update the data base at their own speed.
Another glitch in the system insureds should consider is that we now have the “third party paper chasers involved, such a Release Point, Clamify etc.”, who if they don’t see the paperwork right away, are contacting treating physicians on a daily basis. Even they, don’t account for the time it takes to get paperwork scanned in, and uploaded. Ignoring their own systems disorganization doesn’t help at all.
If insureds wanted to work WITH the system, they could send in their update information about 5 days prior to the due date, but who really does that? Although I have always recommended making additional physician appointments before walking out the door from the last one, most people don’t do that either. Now that we’re having to manage through insurance paperwork chaos, sending and receiving information to insurance companies is a hassle at best.
Hopefully, this post will help insureds and claimants better understand what is involved with shared communications. Stop chasing for the “paper verification” a day after its sent. WAIT. It’s not going to be on the system in what you’d consider to be a timely way. It’s just not going to happen.
Insureds might be slightly better off by faxing, or emailing, their information, but remember a human being still needs to scan it in and upload to the appropriate data bases. I still don’t recommend using website portals due to the Trojan tracking software located there.
I think insureds need to “play” the system instead of the “system” playing them by getting all nervous and upset. Fax or email information, making sure you get a fax or email confirmation. Then, if you’re told the information didn’t get there, wait a few days, and fax again with a copy of your first confirmation, for the record. It make take faxing more than once, but it’s their mess, not yours.
