Tuesday, October 30, 2012


The average amount of time that it takes for a health insurance company to re-process a claim is around 90-120 days. That's a conservative estimate if the reason that the claim is being reprocessed is complex. For more substantial issues you're looking at a minimum of 120 to 180 days. It's not uncommon for insurance companies to take as long as three years to resolve claims errors.

I could go into all the reasons that it takes that long to re-process a claim but I think I'll save that for a later date. At this stage in the game, you're probably more interested in just how to get the dang claim paid!

The first rule of getting a claim reprocessed faster is to be THE squeaky wheel. By that I mean be THE absolute number one person that they want to get rid of before everyone else! You have to get so familiar with the customer service department that they recognize your number on caller ID. Be the patient that calls every day, or at the very least every week, just to see how your claims issue is coming along. Pretty soon they'll tire of your voice and they'll push your claim through just to get rid of you because they know if they don't, you're going to call just like clockwork.

The second rule of pushing your claims issues to the forefront is to provide and obtain all the details you possibly can. You can never have too many details when it comes to getting a claim re-processed. Getting a person's name is somewhat elementary and goes without saying but it's amazing how many people don't write down the name of the person they spoke with.

It pays to go a bit further, however. Get a direct extension and the exact department from the person that is helping you with your claim. Get the name of their supervisor. Specifically request a reference number and whether or not a new claim number will be issued.

The last rule after you have all the details is to ask when you can expect the claim to be reprocessed and when they will call you back. By asking those two questions, you'll be setting an expectation up front that you're expecting accountability.

If you implement these three little rules when you call to get your claim re-processed, you can bet you'll see a quicker turnaround time in reprocessing your claims. Most likely the initial time you invest for the first claims issue will pay off for any future issues as well.

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