Strategy Review
In most cases insurance companies have 45 days to process the claim once they receive it. Key words, process, and receive. Remember, they make up to 50% of their profit from interest earned on your money. Not just premiums they have collected from patients. The insurance company strategy comes in four basic flavors.
- Delay claim submission
- Prevent claim submission
- Prolong the “processing” time.
- Take the money they paid back from the doctor.
Now we know their motivation. If you look at the chart below it is pretty obvious. What tactics to they use to make it happen?
Tactic #2 – They Make The Rules –
To begin with, there is no reason insurance companies should delay payment on a claim at all. Technically speaking way more complicated transactions happen every day on wall street. The difference is, by law, everyone has to be paid by the end of the business day on wall street. What’s the difference here? Power. They have the money, they have the power, they make the rules, they get to delay, but not forever. So the first way to rig a system is to gain the power to make the rules. The submission process and the payment process are intentionally way more complicated than they need to be. That is their second tactic. First the power is gained then it is used.
