Lanzko Insights/The Claims SPOT

Medicare Secondary Payer | SPOT on Ops

Medicare Secondary Payer Allows Direct Data Entry For Small Reporters Of Claims
ByMarc Lanzkowsky June 2, 2010

A new change to the Medicare Secondary Payer reporting will allow those entities with a small number of reports the ability to key in individual claims. This will alleviate the need to create, test and manage a data feed. While not without limitations, the news should help those smaller reporting entities that had been struggling with the onerous requirements. The method is limited to those reports that have less than 500 reportable events in a year. Read more about the changes in today’s post.

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Claims Writing Workshop | SPOT on Issues

The Claims Writing Workshop: Write How You Speak! Just Leave Out The Color Commentary
ByGary Blake June 1, 2010June 1, 2010

From our new contributor Dr. Gary Blake, we learn about writing and claims. Dr. Blake is a Port Washington, NY-based writing consultant who presents claims writing webinars and seminars throughout the United States. In his first post on The Claims SPOT, Dr. Blake discusses writing the way you speak without the color commentary. As he states, “write using the model of speech’s simplicity, directness, and warmth. Just don’t mirror speech’s unplanned distraction and tendency to ramble. “

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My SPOT

Welcome Claims Magazine Readers
ByMarc Lanzkowsky May 26, 2010May 27, 2010

The Claims SPOT is now a featured blog for Claims Magazine Identifying opportunities is easier when you know how to SPOT the issues Welcome Claims Magazine readers to The Claims SPOT. I founded The Claims SPOT to be a forum for new ideas and insights into the world of Claims. Bringing together the best and…

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Negotiation | SPOT on Issues

3 Settlement Techniques That Will Help Move A Case To Resolution
ByMarc Lanzkowsky May 25, 2010May 26, 2010

As a claims professional, you know you have cases that will ultimately settle, and can settle, but for some reason or another you just can’t get there. Recently I came across a great blog dedicated to providing different ideas and solutions surrounding the settlement process. Settlement Perspectives, written by John DeGroote, provides insights and “thoughts on how to resolve disputes and get your deal done.”

In today’s post I comment on three techniques suggested by John – Managing Expectations, Decision Trees and Offers of Judgment – and show how more out-of the-box approaches can be a useful way to move a case to resolution and settle claims faster and cheaper.

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Best Practices

How Do You Effectively Manage A TPA? Speak Up And Be Active!
ByClaire M Louis May 20, 2010May 20, 2010

Become The Squeaky Wheel To Actively Manage TPA Outcomes As claim practitioners, most of us are familiar with what to look for when we shop for a third-party claim administrator (“TPA”). One recent discussion on this blog cited such elements as claims systems, data reporting capabilities, and quality control (6 Essential Elements When To Explore…

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My SPOT

The Claims SPOT Expands With New Contributors And More Insight
ByMarc Lanzkowsky May 19, 2010

Another Bright Idea The Claims SPOT is expanding to provide even more information and updates on issues affecting the world of claims. Over the coming weeks additional contributors will share insight into claims issues and suggest further ways to help claims and claims related entities lower costs and become more efficient. In addition to our…

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Best Practices | Claims Auditing

2 Chores that should not be neglected to become a stronger claims organization
ByMarc Lanzkowsky May 18, 2010June 5, 2011

Lets face it – no one really likes to do mundane things. Nonetheless, it’s those very chores that have to be done regularly to ensure a strong organization. Like cutting grass, the longer you let it go the worse it is for your grass, and the harder it will be to fix the mess that has been created. There are certainly enough chores that need to be done in the world of claims that no one likes to do. You know what they are – those things that you would prefer to not have to get to. They can include writing notes on files, keeping a diary and paying bills. But as any good claims handler knows, if you fail to do those tasks regularly not only won’t your grass grow, but you will have quite a clean-up.

Two chores that can really help claim departments grow nice healthy grass are in the areas of training and managerial assessments. Learn a few chores that have to be done but will help grow your organization.

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Commentary

Is Your Caims Department Becoming A Bus Company?
ByMarc Lanzkowsky May 12, 2010June 8, 2012

Claims departments can get into ruts and begin to act like bus companies. As Seth Godin, business author, recently wrote in his blog – “We all have a vision of the typical bus company, slowly moving people from place to place, going through the motions and showing a lot of fatigue.” In this weeks post, I point to some ways claims department can avoid the bus company mentality and figure ways to stay fresh and motivated.

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SPOT on Ops

Does Hiring More Staff Improve Claims? How To Know When The Time Is Right
ByMarc Lanzkowsky May 3, 2010May 5, 2010

Deciding when to hire new staff is always a difficult question to answer. It’s even harder in a tough economy. In this week’s post I explore what to consider before hiring. Developing a staffing model and exploring internal metrics should be done before making a decision. But how do you create a staffing model? I suggest a few methods for developing a staffing model that makes sense. Before you bring on more staff review your staffing model, see if there any trends affecting file loads and take a quick look inward at your operation. Once these assessments are completed, you will be in a better position to know if hiring is the right decision.

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Due Diligence | SPOT on Ops

6 Essential Elements To Explore When Choosing A Third Party Administrator
ByMarc Lanzkowsky April 27, 2010September 6, 2011

A Third Party Administrator (TPA) is often the best way to handle claims for an organization. Many self-insured and captives choose to outsource their claims instead of creating their own internal operation. Whether to get expertise in a particular areas, or not wanting to invest in the infrastructure to build a claims department, using a TPA can be a smart business decision. So what make a good TPA and what should you look for? In order to find out you must conduct a comprehensive due diligence of the TPA you are about to hire. This is especially the case when that TPA will be holding and managing your claim dollars. Besides understanding the financial strength and capabilities of the TPA, it is also important to know whether they will be able to meet your data needs, provide consistent claims handling, and work to lower costs where they can.

In this weeks post I address 6 essential elements, and questions, that should be explored as part of any due diligence when selecting a TPA

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