Help for a rookie

[dnkies]

Hello All,

I am getting ready to hit the ground running and have most of my infrastructure set up (bank account, uniform, brochures, etc...) I am looking for some step by step advice on how to handle the whole insurance billing part of the business. I am just very unclear as to how I handle the insurance companies if the clients choose to have me bill their insurance. I also dont know what the purpose of the "networks" is. I looked at several posts on this topic, but it seems like most of the posts are worded for people who know what the heck they are doing....but I have no idea. Just looking for some helpful info that a roookie like myself can follow.

Thanks so much.

[dnkies]

I spoke with KGobin from Delta on this topic this morning....talk about quick response! Korey handled my questions and concerns and set me straight! Thanks for all your help Korey.

[Brent Deines]

Dang it Korey, you beat me to it again! Oh well, maybe this will be helpful for other newbies.

One of the reasons you are having trouble finding what you want on this forum us because people often used title topics like you did, that are not specific to the question. A more appropriate title for this topic would be "Insurance Network Help", or something along those lines.

Another name for an insurance billing network is Third Party Administrator, or TPA. Their function is to process claims and collect money for insurance companies, which in theory is more cost effective than insurance companies processing all of the claims themselves. Here is how a typical insurance job works:

Assumption: You have already found a customer in need of a rock chip repair, established that they have comprehensive insurance (checked their insurance card), and have explained that in most cases their insurance company will waive the deductible and pay the full cost of the repair so there will be no out of pocket expense for them. Your customer decides they would like you to perform the repair and bill their insurance company.

You call the claims number printed on your customer's card. More often than not that phone number does not go directly to the insurance company, but to the TPA who is handling all of their auto glass claims. You explain to the TPA that you have a customer who would like you to repair their damaged windshield, verify the customer's name, the make model and year of the vehicle, the policy number, the location of the damage, the date the damage happened, the size of the damage, etc. The TPA will then ask to speak with your customer to verify everything that you just told them. This is where there is a potential for the TPA to steer the customer to another glass shop or windshield repair specialist, so if at all possible I suggest you make this a three way call or use a speaker phone, and be sure to let the TPA know that you will remain on the phone. A TPA is not supposed to steer work away from you, but anyone who has been doing this very long knows it does happen sometimes.

After the TPA speaks to your customer they will give you an authorization number to use when you submit your claim. Once you have the claim number you are free to perform the repair.

How you submit your claim to the TPA depends on which one you are working with and a few other variables that you will have to determine on your own, but let's say that in this case the TPA is SGC, I am the repair technician, and I don't have a wi-fi setup for my laptop. I fill out an invoice at the time of the repair and give my customer a copy, then when I get home at the end of the day I login th the SGC website and submit all of my SGC claims, which only takes a couple of minutes each and costs me nothing. Next I login to the HSG website and submit all of my HSG claims to them. This same basic process is what I use to bill all of my insurance claims through each TPA except those that go through Lynx. For my Lynx claims I use a service called IBS, who has the capability of sending Lynx information electronically (EDI). There are a number of services that will submit your claims by EDI for you depending on how fast you need to be paid, how much holding you need and how much you are willing to pay for that. I choose IBS because of their low cost, superior customer service, and the fact that no matter how big I get they have a billing solution that fits my needs. There are less expensive services and there are more expensive services so you will need to do your homework before selecting someone to submit your claims to Lynx for you. Your business model should dictate who you choose for this service, not what everyone else uses, and not by price alone. You can also submit your SGC and HSG claims through an insurance billing service like IBS and depending on your volume that may be in your best interest, but I think most windshield repair technicians these days choose to bill SGC, HSG and others direct so they don't have to pay any fees.

Aside from steering and the initial setup, the main aggravation is the time it takes to call the TPA. We get around that by asking the customer to sign a work order agreeing to pay for the service if their insurance company does not. That allows us to get started on the job before calling the insurance company and guarantees payment in case the insurance company does not give approval. I don't necessarily recommend this for others, but it does save about 10 minutes on every job we do.

If you have a laptop and wi-fi setup you can submit your claims individually during the repair process, which will also save you time.

If you are a Delta Kits customer we will be more than happy to help you get setup with the major networks. Once you are signed up all you need to do is follow the simple steps above. It's really very easy but new technicians often get intimidated by the process and either don't do it at all, or pay for more than necessary to have someone do it for them.

[michaelrockchip]

I was a rookie about a year ago. I then joined with Quick Fixx and they do everything for me. It isn't just for rookies either. I was talking to another Quick Fixx tech and he has been doing windshield repairs for almost 15 years and told me that he was very happy with Quick Fixx also. Anyways, just an idea. You can google them. Search for quick fixx rock chip. It should be one of the first that pull up. You can also search for free rock chip repairs and they are also one of the top searches. They have really helped my business.