PostHeaderIcon If you don’t like the answer…

A significant part of a claim assistance professionals work consists of follow up with insurance companies.  We send claims, appeals, and other items, and wait, usually 30 days, to have it processed.

Today I called an insurance company to follow up on a claim submissions as well as two appeals.  I was told by the customer service representative that they cannot do anything until the Human Resources department update specific files.  I was advised to request this information to be sent to the insurance company directly from the member’s HR Department.  Having been doing this for several years, I’ve learned not to argue and didn’t get carried away.  After all, this is business as usual….

So, naturally I waited about 10 minutes to simmer over and called again the same insurance company, the same phone number, and naturally about the same claims and appeal letters.  The second call yielded a completely different result.  The customer service representative checked the claims, verified that all information is correct, and on the file, and promised to reprocess these same claims by the end of this week.

The lesson of my story: if you decide to call your insurance, and push all the necessary buttons on your phone, while lucky enough to get a life human being, the answers aren’t always the same.  Therefore, if you don’t like to response, call again and repeat as necessary.

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