Volume 10, Issue 6 - November/December 2008

T h e L a w

Document/Data Preparedness
by Chuck Lloyd and Deb Lingen

IN OUR LINE OF WORK, WE SPEND an awful lot of time analyzing information. We gather data from both our clients and the other side and try to figure out an offensive as well as a defensive theory and then attempt to determine how each fact, each tidbit of information, fits within the mix. Whether it’s a claim based on short pays or steering or whether it’s responding to a regulator or an insurance company, mastering the facts and gaining control of the data is an essential element of success.

Getting organized and having a handle on your data now will save you time (and therefore quite likely money) and headaches later when you really need to be able to call upon your information. It’s just like the old cliché that the time to fix your roof is when the sun is shining.

To begin, understand what information you have available to you. Most of you should, by now, be generating the bulk of your invoices by computer. Depending on the software that you use to generate your work orders and invoices, do your EDI billing, etc., there is a wealth of information stored about your business. The real question is, can you use it? We have to admit, we’ve been spoiled by clients who, with very little effort, are able to generate spreadsheets setting forth dates of service, customer names, policy numbers, part numbers, amount billed, amount paid and every other item of data that shows up on work orders and invoices.

Recently, however, we were assisting a client in the midst of an investigation who had a need to identify every transaction with a particular insurance company and then to organize that data by part number. Unfortunately, the client’s point-of-sale software was so limited that we could generate a report showing every transaction with the insurer, but could not list all of the data about each transaction. The only way we could get the information was to regenerate every invoice, print every invoice to hard copy and input the data into a spreadsheet by hand. Unfortunately, the insurer involved was not one of those three- or four-windshields-amonth companies. As a result, the process was time consuming and expensive.

Fixing Your Data “Roof”
Now is the right time to start fixing your data “roof.” Make inquiries of your point-of-sale software company and ask them if you have the ability to generate a report showing every item of data input into the system. If they tell you that you can’t do that, ask them why not and push them to deliver an upgrade that will do just that. If they won’t, you may want to consider talking to other point-of-sale software vendors.

When the Independent Glass Association (IGA) convention rolls around next year (May 14-16 at the South Point Hotel in Las Vegas), there will undoubtedly be a few such venders present at the trade show. Show them this column or have them come talk to one of us about what we would expect to be able to do with the data and then have them tell you whether they can meet that challenge. We know it can be done because, as we noted above, we’ve got clients who can do exactly that.

Another report that you need to be able to generate with relative ease is a payment report. How much did insurer X pay you for each of the claims that you have submitted? Chances are, this is another category of data that goes  into your software. Here, however, the data comes from the outside, either in the form of electronic funds transfersor checks. You should be holding on to documents that reflect payments so that you have a back-up for the data that you have entered into the system.

We are big fans of scanning paper and retaining images rather than taking up space with boxes and boxes of paper. The cost of storing material on hard drives is significantly less than the cost of storing the same material in hard copy. It is easy enough to back up your hard drives and periodically copy the stored images onto CDs or DVDs, which will keep the data readily available if it is needed.

Keeping Electronic Files You should also consider scanning pricing letters and other communications received from insurers and holding on to them in a similar manner. While it may seem like one pricing letter from a third-party administrator (TPA) is just like all the others, that’s not entirely true. One thing that is interesting to show is the historical trends of reimbursements from a particular insurer. While you can say the discounts have been getting deeper and deeper, that claim is much more powerful when you can document exactly how that is true over time. Then, when you couple that with your payment report showing what affect that has had on dollars paid to you, not just discount amounts, suddenly you’ve got some power to your position.

Most of the information that you will need in dealing with insurers, regulators and the like you probably already have. It is a matter of being able to get that data into useable forms so that you can be both quick and efficient in providing your information. Moreover, your presentation will be that much more powerful because you’ll have the ammunition to back up what you claim.

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No reproduction of any type without expressed written permission.