Frustrated with third party administrators?

[HealthGuy]

For whatever reason I recently have had a rash of submitted applications all go to medical records review....In every single case the applications have been held up from either two weeks to over 30 days. Ridiculous. Either there has been hold ups from third party administrators not following up, clients not following up on additional required signatures, or Docs offices requiring their own special signatures on top of all the other required signatures before medical records are released. This is absolutely nuts. Any way as an agent that we can help oil the wheels to get applications processed other than CONTINUALLY reminding clients to sign and return authorization forms and TELL my clients to remind the docs offices to release records by calling the doctors themselves? I am at the end of my patience level with some of my clients, Dr. offices, and third party admins pulling records on behalf of the insurnace companies...this process is cumbersome and endlessly frustrating. No wonder people hate the insurance process...What more can be done than cautiously reminding folks when they submit an application anything can happen? Any construtive, tactical suggestions would be super appreciated. Thanks in advance.

 

[indmedins]

Buy leads that aren't sick.

 

[taterpeeler]

Buy leads that aren't sick.

thats funny as hell... but so true, deal w/lead companies that allow health condition filters

 

[insuranceexec]

For whatever reason I recently have had a rash of submitted applications all go to medical records review....In every single case the applications have been held up from either two weeks to over 30 days. Ridiculous. Either there has been hold ups from third party administrators not following up, clients not following up on additional required signatures, or Docs offices requiring their own special signatures on top of all the other required signatures before medical records are released. This is absolutely nuts. Any way as an agent that we can help oil the wheels to get applications processed other than CONTINUALLY reminding clients to sign and return authorization forms and TELL my clients to remind the docs offices to release records by calling the doctors themselves? I am at the end of my patience level with some of my clients, Dr. offices, and third party admins pulling records on behalf of the insurnace companies...this process is cumbersome and endlessly frustrating. No wonder people hate the insurance process...What more can be done than cautiously reminding folks when they submit an application anything can happen? Any construtive, tactical suggestions would be super appreciated. Thanks in advance.

My secretary just signed us up with this company about a month ago, that has been great. I think it is called EIS, or ESA. I will get you the details on Monday when I get back to the office. Have a great day and I look forward to talking to you soon.

 

[Russ]

For whatever reason I recently have had a rash of submitted applications all go to medical records review....In every single case the applications have been held up from either two weeks to over 30 days. Ridiculous. Either there has been hold ups from third party administrators not following up, clients not following up on additional required signatures, or Docs offices requiring their own special signatures on top of all the other required signatures before medical records are released. This is absolutely nuts. Any way as an agent that we can help oil the wheels to get applications processed other than CONTINUALLY reminding clients to sign and return authorization forms and TELL my clients to remind the docs offices to release records by calling the doctors themselves? I am at the end of my patience level with some of my clients, Dr. offices, and third party admins pulling records on behalf of the insurnace companies...this process is cumbersome and endlessly frustrating. No wonder people hate the insurance process...What more can be done than cautiously reminding folks when they submit an application anything can happen? Any construtive, tactical suggestions would be super appreciated. Thanks in advance.

Doctors offices will sit on APS's for weeks sometimes. I always call the office...talk to the lady that handles the insurance, try and talk nice with her in hopes that she'll help anyway she can.

Paramed exams will usually delay issue by around a month. I have a life case I wrote 2 weeks ago, got the paramed and urine specimen done yesterday. Now it will take 2 more weeks to get paid on it, IF it's issued, which looks likely.

Job requires patience, sometimes to the point of needing a drink or a

 

[Colorado Newbie]

Lets do the break down on how many are involved in this process

1. client
2. underwriter
3. medical record retrieval company such as EMSI
4. the person that is supposed to go copy the medical records (they have 2 weeks to get there)
5. person in charge of medical records at the doctors office. I recently had one tell me she was way too busy and would get to it when she can and that just might be at least 3 weeks. quick word with the office manager fixed that
6. you the ever so frustrated agent after waiting 4 weeks for SOMEONE to get off their butt and do something for your client

There clearly has to be a better and more effecient way of doing this. The way I see it is that the more hands that are in the pot the likely our clients will get burned. Oh, in a perfect world all of our potential clients that come to us that say they have never had any health issues would be telling us the truth. Oh sorry, forgot about that Hep C thingy​

 

[somarco]

Not much you can do except move on to the next prospect.

 

[HealthGuy]

EIS, or ESA??? Anybody know what this is - is somebody spamming here promoting something? I wish I understood why people post vague things like this....

 

[Norwayguy]

For whatever reason I recently have had a rash of submitted applications all go to medical records review....In every single case the applications have been held up from either two weeks to over 30 days. Ridiculous. Either there has been hold ups from third party administrators not following up, clients not following up on additional required signatures, or Docs offices requiring their own special signatures on top of all the other required signatures before medical records are released. This is absolutely nuts. Any way as an agent that we can help oil the wheels to get applications processed other than CONTINUALLY reminding clients to sign and return authorization forms and TELL my clients to remind the docs offices to release records by calling the doctors themselves? I am at the end of my patience level with some of my clients, Dr. offices, and third party admins pulling records on behalf of the insurnace companies...this process is cumbersome and endlessly frustrating. No wonder people hate the insurance process...What more can be done than cautiously reminding folks when they submit an application anything can happen? Any construtive, tactical suggestions would be super appreciated. Thanks in advance.

This has worked for me when the doctors office is sitting on there butts or when the record retrieval company says one thing and the doctors office says another. If you have a strong enough relationship with the client do a three way call with the client and the doctors office and get them to fax the records to you...I've found that that I get the records within a days 4 times out of five this way..The doctors office already has written documentation with client signature and now they have the client on the phone asking them to expedite and with me on the call as well they have someone that will give them 1 number to send the paperwork to then forward the paperwork to the life company underwriter.

Like I said this works about 4 out of 5 times but I only do this if I have a strong enough relationship with the client..the call goes like this...Joe as you know the insurance company has ordered your Dr's records and has sent payment for those records...Your doctors office as you can imagine gets a ton of these request, I find if we call them together they tend to view request from there patients higher than they do the insurance companies..wouldn't you (they laugh) then I tell then I'm going to confrence in there Drs office. and make the call.

Peter

 

[Colorado Newbie]

I am so frustrated at the moment about this whole process of getting medical records!!!!!!!

1. Application submitted on 11/09/08
2. Medical records requested 11/11/08
3. Medical records recieved 11/20/08
4. 2 pages received were bad. records requested again 11/25/08
5. called doctors office 11/28/08 to let them know request was coming for 2 pages to be resent
6. I noticed 12/12/08 that the insurance company is still waiting on medical records.
7. I called docs office on 12/12/08 and they have yet to recieve any request for medical records.
8. I call EMSI on 12/12/06 and they claim to have contacted Health Port to get the records on 11/28/08 (Health port is the company that the docs office uses for recording medical records)
9. I call Health Port on 12/12/08 and they say they have not recieved any new request for medical records.
10. I try calling Health Port again today (12/16/08) and sure enough they recieved a request for the medical records during the afternoon on 12/15/08.
11. Health Port tells me that they have sent the person that retrieves medical records. They also inform me that this person has 1 week to go by docs office to get them.

Ok, I admit that I should have kept a much closer eye on this. This would have never taken this long to clear up had I been on the ball with this one.

However, this is a good example of how messed up the system really is. Their are a total of 5 different hands in the pot. How can anyone expect to get good service from or health care system when they are counting on 5 separate initities to actualy come together and work flawlessly?