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Archive for the ‘Insurance Industry’ Category

Different Geographies with Different Rules can Delay APS Retrieval

Tuesday, April 1st, 2008

For a BGA, getting records as fast as possible is one of the most important aspects of APS retrieval. Over the years, and after retrieving 100’s of thousands of records, MediConnect Global has perfected retrieval with its patented online process that works equally well for the provider next door or across the country—a process that can provide APS retrieval in a matter of days.

The question is then, why isn’t the time required for retrieval uniform in all regions and geographies? It can vary by area from a few days to a few weeks- why?

The answer is a fairly broad one. The biggest delays are usually caused by either specific state and/or specific provider requirements.

A good case study is California. In California providers are not required to copy their medical records as an extension of HIPAA privacy rules. When an APS request is made, arrangements need to be made to have a copy service make copies—an added step. MediConnect Global maintains premium contracts with key copy service providers in California to expedite timely service.

In other regions, there are large copy service companies who contract with providers to manage their medical records. They may have their own specific set of rules that need to be followed to obtain APS records. Rules that include special authorizations, minimum amounts of time such as 14 days before checking back on status, and not following up directly with the provider all have the potential to slow the process down.

Other potential hold ups include specialized authorizations that providers may require. MediConnect is a strong proponent of universal authorizations that allow for one form that works for everyone and meets HIPAA requirements. Until the day a universal is available though, it is important to make sure all special authorizations are provided with your request.

In all these areas, MediConnect streamlines the process constantly looking for ways to maintain and increase the speed of retrieval as much as possible so BGAs can obtain their applicant’s records quickly and as cost effectively as possible. Insuring orders are completed properly and all special handling features are implemented helps maintain efficiency.

How Chronological Sorting Can Help Your Underwriting Process

Monday, March 31st, 2008

MediConnect’s APS record retrieval system saves you time and costs in a new applicant’s process. Often when an APS record is retrieved from a provider office the pages are in no particular order, which forces you to spend valuable time organizing the record before you’re able to review it.

With MediConnect’s new Full Chronological Sorting service, underwriters can get the record already sorted. Underwriters prefer getting the most recent medical activity at the front of the record, but if they prefer, they can have the record sorted with the oldest entry first.

You can order Full Chronological Sorting right now by selecting it in the Services and Options portion of the main order form or by contacting your account manager (carriers only).

Special Authorizations - Avoid the Pain!

Monday, March 31st, 2008

The vast majority of healthcare providers will accept generic authorization forms for APS record requests. However, a small but vocal minority require their own customized “special authorization” forms. If you don’t complete these forms correctly it can really slow the process down.

So take some time to double-check just a few critical items before sending special authorization forms in. It will save you time and headaches - and facilitate a smoother and quicker retrieval process than what otherwise might have been.

First (and most importantly), always return completed special authorizations to MediConnect. The special authorization has the request number pre-printed on the top of the page. Simply fax it to 888-489-8706.

Other Items to Check:

  • Is the form complete? (No blank lines).
  • Is it signed (by applicant) and dated?
  • Is the provider requesting an original? Mail in the original - don’t fax it back.
  • Is an “Original Special Authorization” requested? A printed, copied, or faxed blank special authorization can be used, but it must be mailed in with the applicant’s original wet signature (not copied or faxed).
  • Is a “Unique Special Authorization” requested? The provider wants the exact same special authorization form completed, signed and dated. Mail the very original paper form (completed) back to MediConnect.

By checking these few items and paying close attention to any instructions from the provider, special authorizations will be approved faster and more smoothly, ensuring your APS records are returned as quickly as possible.

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