Author Topic: Claims Processing Time  (Read 2295 times)

StephD

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Claims Processing Time
« on: November 26, 2008, 03:13:42 PM »
Has anyone noticed a slowdown of how long it takes to have a clean claim process and pay?  United has always been notorious for their slow and/or incorrect claim processing, but it is taking 2 to 3 months to get paid,  I have to call on EVERY claim I file now.  Usually they deny incorrectly and when they finally pay, it is not the correct amount.

A rep at a DME company remarked that all of their claim processing has slowed down dramatically.  Is anyone else experiencing this and if so, is it any particular payor?

bdhobbs1

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Re: Claims Processing Time
« Reply #1 on: November 28, 2008, 01:13:10 PM »
I've noticed that Medicare has slowed down, our payments for November were down because of the slow down in claim payments.

But, keep in mind this is the peak time of the year for claim submission, kids are in school and getting sick and the number of claims to process have increased.  Plus, claims examiners are taking vacation time around the holidays, so claim production areas are not fully staffed.

Michele

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Re: Claims Processing Time
« Reply #2 on: November 29, 2008, 08:15:09 AM »
We haven't noticed what you are describing.  There are always the notoriously slower payers but I haven't noticed anything different in the past few months than we have had for the past 5 years.  UHC is definitely one of the harder payers to work with, but we haven't had the problems you have described.

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Michele

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Re: Claims Processing Time
« Reply #3 on: November 29, 2008, 08:18:39 AM »
BDHobbs1 is right, there are a lot of vacations around this time of year and it does affect the claim processing time.  But if you are submitting clean claims electronically it helps.  They can actually go thru without human intervention which will help with the processing time.  Of course that will be affected by the type of claims you are submitting.

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Trisha Reyes

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Re: Claims Processing Time
« Reply #4 on: December 04, 2008, 12:30:25 AM »
what state are you in and have you heard of the promt pay statutes and filing a complaint with your states insurance commissioner? Those who scream the loudest will be heard first. Insurance companies some times need a nudge or at least to realize that you are aware of your rights.

good luck!
Trisha

StephD

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Re: Claims Processing Time
« Reply #5 on: December 04, 2008, 03:37:02 PM »
I am in Texas and yes I know about the prompt pay laws.  However, if you do a google news search you can read where UHC has been fined millions of dollars for a large number of violations.  It hasn't seemed to change the way they process claims.  Alot of providers in my area won't take UHC any more because of all of the problems. 
I have been doing paper claims because I don't do a large volume of billling.  However, I am going to start filing my claims online with them and see how that goes. 

http://www.insurereinsure.com/BlogHome.aspx?entry=258
« Last Edit: December 04, 2008, 03:56:30 PM by StephD »

Michele

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Re: Claims Processing Time
« Reply #6 on: December 04, 2008, 05:06:30 PM »
I would certainly think the online process should speed things up, since it is their system.

Good luck.  :)


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