by Tracy McQuilkin
A claim moves through our system like a train on its track until a “pending” or “on hold” stops the claim. Some claims have to take extended stops in their journey toward claim settlement.
Pendings and On Holds not only stop the claim train progress, but many times stop it for a long period of time. Pendings are claims where the contract we have on file does not match to what is requested on the claim we received. Pendings require more work for many people. Just think if the customer had the same copy of the contract we have on file--how many less Pendings would we all have to deal with? Luckily, you have that option in the ContractPro® application to print or email the contract you created (the one we have on file to verify claims against) to your customers.
On Holds are slightly different: they are “held up” because the claim itself is missing something. If your customers have a contract that stated what is required when submitting a claim, that helps create less On Holds. That’s where sending the contract from the ContractPro® tool comes in handy, too.
Think of it like this: if you were taking a train trip from Tampa, Florida, to Torrington, Connecticut, would you like the train to stay on track or take an unexpected detour—or worse, go off the tracks—that keeps you stuck for a few months somewhere between your originating city and final destination? Claims are no different, do what you can to avoid Pendings and On Holds up front to avoid that crash later.