Speed of ins. payments

Diane in FL

I've been asked to do a quick survey and create a report giving an idea of how well insurance carriers are paying on claims. We are experiencing problems like claims being submitted correctly by doctors' offices and then within a month and even up to a year or two after the original claim, employees being told they are responsible for payment, because the insurance has not yet paid for whatever reason.

If you are willing to help me with this, I need to know:

-Company size (micro, small, med, large)

-Location/State

-If you use a broker or self-insure

-Type of difficulty, e.g. first claims, all claims, intermittant

-Type of claim, e.g. big ticket items (MRIs, cancer treatments, heart surgeries, etc. or regular claims (office visits, bronchitus, medications, etc.)


The information will be confidential, and I'm happy to share the survey results with participants.

Please respond off-list to: [email]dkf_mail@bellsouth.net[/email].

I need the info as soon as possible, as I've been asked to have the completed report turned in Friday morning.

Oh, the life of HR!

Thank you!

bsa

Someone at your office doesn't have enough to do!!
I am 50+ in Texas and we use a broker.
I don't know much about our claims payment history, but the few I am aware of are paid within 3 weeks, give or take a little, when the doctor files timely and correctly. I know that I have had a few big ticket items and many regular claims. The regular claims usually don't get fouled up. The big ticket claims are confusing because of the deductible, then 70%/30% until stop loss, then 100% and who can guess which bill gets paid first. Claims are processed FIFO (first in first out). I advise my employees to pay a minimal amount until all the claims have been filed and processed.