I got an email from the family member of one of our long term care claim clients yesterday. He wanted to know why they haven’t heard anything yet on his Dad’s claim – after all, we had been working on the claim for two weeks already.
Being consummately human, I wanted to fire back a smart remark in defense of our hard-working staff. Somehow, GRACE got ahold of me though and I responded patiently instead (or so I hope!). So, in case you are having the same issue, here is the deal…
Long term care claim filing is a SLOW process to get a long term care claim approved. The fastest our (professionally trained!) staff have been able to do it is one month. And that was FAST – more typically from the start of filing until you have an approval letter in hand, it can take 6 to 12 weeks (or longer depending on the complexity or difficulty of the claim). That is the bad news…
- The good news is that long term care claims frequently back-date the start of the claim to some earlier time window. Thus, by the time you get your long term care claim approval, you may have already “been on claim” for weeks or months. Getting this back-date can be tricky but it is worth everything we do here because we know it means everything to the family to have the claim start as early as it possibly can on the calendar, so that the claimant receives the full amount of their policy!
Why does it take so long, you ask? Well, because every person involved in the complicated long term care claim process is a human. Humans are prone to error, delay, procrastination and mistake. When you add to that the inevitable challenges of technology (i.e. the fax only delivered 6 of the 8 pages so you have to re-fax…but only after you call and find out that there are only 6 of 8 there…and you get THAT information after you call on 3 successive days speaking to 3 different people trying to figure out if the fax even got there at all and if got in the claimant’s file), there is just a host of reasons that things slow down and break down.
This is why we have a system at our shop to help manage the long term care claim process. We spend lots of small increments of times over many successive days contacting doctors, hospitals, rehabs, past and current care providers to get correct documents in their hands so they can fill them out and return them to us….so we can CHECK them for accuracy (and return to have them redone if they are wrong)…then we fax the correct forms to the long term care insurance carrier…so we can check up to see if they got there in total.
Filing a long term care claim correctly takes time. It takes patience. It takes help from people that you only talk to on the telephone so you need people skills and systems to monitor all the moving parts. I am reminded of the old adage I learned when I worked in TV production:
You can have it fast, quality, or cheap….pick two.
LINKS TO HELP WITH LONG TERM CARE CLAIMS
- Choosing Long Term Care Providers
- Change of Address for filing Long Term Care Claims
- Why Wont the Carrier Talk to Me?
- HIPAA Release Forms and Long Term Care Insurance Carriers
- Long Term Care Claims: Document Everything!
- Tips for Getting Paid on your Long Term Care Claim
- Free Worksheet for Long Term Care Claims
- Dutiful Heir(ess): Quality of Life and a link to Book about filing Long Term Care Claims