MAKE YOUR DEMANDS CREDIBLE!
Claim Remedy offers a time-tested and proven (see our testimonials) concept for recovery of your insurance claims. Our goal is to empower our members with the law in order to effectuate prompt payment of insurance claims. Faster payment means reduced “Days in Accounts Receivable” and increased cash flow. The fact is, accounts receivables will lose value over time. Let’s take a look at the hierarchy of CREDIBLE DEMANDS, from weakest to strongest:
The Credibility Factor – From Very Weak to Very Strong:
Very Weak – The un-informed phone call:
Through no fault of their own, most providers just don’t have the time or resources to stay fully informed in today’s ever changing healthcare/legal environment. It’s become the rule rather than the exception to simply accept what insurers say at face value rather than challenge the delays that can cost you money. For example:
Insurer says, “We paid the insured, get your money from them.”
Many providers would simply accept the insurer’s statement as fact, rather than offer a challenge. Without the knowledge of, or the access to the appropriate laws to back them, many providers are simply at a loss of how to respond, and feel powerless to affect any change in the claim’s status.
Weak – The un-informed letter:
Providers, who refuse to accept the insurers misdirection, as in the above example, may attempt to follow-up with a letter. This added step is costly for the provider, both in time and resources. Once again, without the specific laws to give the letter credibility, any demand for payment made therein, will ring hollow with the insurer.
Strong – The informed phone call:
Our site is designed to empower our members with the specific laws in response to a variety of “stall tactics” and at the same time add credibility to your demand for immediate payment. Armed with these laws, now the “informed phone call” takes on a whole new flavor. For example:
Insurer says, “We paid the insured, get your money from them.”
Provider’s response, “Well, that’s an error on the part of your company, and no it’s not our responsibility to recover the money from the patient. Texas Insurance Code, § 1204.051 says in pertinent part, and I quote, “If a written assignment of benefits payable for healthcare services is made by a covered person…The benefit payment shall be made by the insurer directly to the physician or other healthcare provider.”
Our website will empower our provider/members with stronger and more credible responses by incorporating the appropriate law into an easy to read suggested response, with a single click.
Very Strong – Attorney Impact Letter:
It is a well-settled precept of collections, that third party involvement creates the strongest motivation for paying on a demand. If this weren’t true, there wouldn’t be 9,599 collection agencies in the US generating revenues of $13 billion dollars. Hence, “third party” involvement in the recovery of money owed has been and will always be a viable tool for reducing accounts receivable. We have taken this proven idea to a whole new level with the Attorney Impact Letter.
In the world of third party collections, a communication from an attorney will prove more effective in motivating insurers to pay, than will communications from a collection agency. But most providers are reluctant to pay up-front retainers or the hourly fee to hire an attorney. We have simplified and made the “attorney impact” process inexpensive and readily available for our members. Our members may select an Attorney Impact Letter, whenever they deem it appropriate. This letter will contain the relevant laws supporting the provider’s position, and will end with a credible and impactful demand for payment. The insurer is informed in the letter, that it is being forwarded to “our attorney” for review and possible action. Our network attorney’s name and address will appear on the letter. Should the insurer decide to “call your bluff’” and contact our network attorney directly, as an added service to our members, our network attorneys will field the call and urge the insurer to pay the claim in order to avoid further action. For just a few dollars per month, our members are able to benefit from the impact of having an experienced healthcare/collection attorney involved in their claims. What’s more, our service not only streamlines the process of involving an attorney and processing the letter, but also handles all steps necessary to keep the member in full compliance with the legal and ethical obligations of attorney involvement. All pertinent claim information is automatically forwarded to the attorney and the entire process is HIPAA compliant.
Want to see it in action? Look at the sample remedy page and then follow the link to an actual live remedy.