Speeding up Healthcare Insurance Claim Resolution!

After reading Article #1 titled "Is Your Business Owed Money?" in my series of "Recover Your Business Profits" blog posts, your business SHOULD have concluded to use a third party which is a profit recovery company to free up those profits which are tied up in late past due accounts receivable.

Even if you are a healthcare provider who has concluded that a 3rd party profit recovery company should be used as Article #1 recommends, you may not have concluded how to handle drawn out late past due insurance company claim payments!

Most healthcare providers ask the question, “Why should I pay a collection agency or debt recovery company to pursue late past due insurance claim payments when I know I will ultimately get paid the money or be told the claim will not be covered at which point I will pursue recovery from the patient?”

The fact of the matter is that selective submissions of late past due insurance claims to a 3rd party for recovery can help the healthcare provider in these ways:

1) Eliminates office staff from spending large amounts of non-value added time on the phone with the insurance company trying to get claim resolution so the office gets more productivity with less staff

 2) Identifies coverage policy for new medical procedures rapidly

 3) Quickly identifies if a claim will be paid or rejected

 4) Increases cash flow by reducing claim submission to claim payment turnaround time

What most healthcare providers do not realize is the policy that healthcare insurers have in place when a 3rd party contacts them on behalf of the provider to get claim resolution on a patient. The untold policy is that insurers elevate all 3rd party contacts to a supervisory level rather letting normal claim handlers manage it. The reason this is done is to insure these claims get priority attention. The priority attention and focus is needed since insurers’ JACO insurance/bonding rates are directly affected negatively by the number of annual 3rd party pursuits occurring since JACO requests statistics from 3rd party suppliers. Governmental insurance oversight agencies also track this to publish the insurers’ slow pay rating.

Healthcare providers who were not previously assigning late claim resolution to a 3rd party and then later did so frequently encountered a regular drop in resolution time from 3 or more weeks to 1 week or less whenever they had their 3rd party contact the insurer via a written demand on multiple occasions. Moreover, some providers have even been contacted by the insurer to participate in a special meeting in order to bargain an ongoing quick turnaround for a stoppage in 3rd party submissions.

Once again, the lesson learned is to involve a 3rd party early even when an irritating insurance claim is not being paid on-time!

Now that you know the insurance secrets, hopefully you have concluded from Article #1 and Article #11 that you MUST use a 3rd party early even with late insurance claim payments to minimize recovery time! If this 3rd party is a profit recovery company you will even better yet minimize the cost of recovery in order to leverage the best alternative to free up those profits which are tied up in late past due accounts receivable!


To inquire about how you can work with a profit recovery company that has an average 56% recovery rate in 40 days for accounts turned over before they exceed 90 days late and how you can do it for a flat @$10 fee per debtor account recovery cost,

call us at:

818-710-0244


Series: "Recover Your Business Profits"
Article: #12 "Speeding up Healthcare Insurance Claim Resolution!"