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Last updated on Feb 19, 2025
  1. All
  2. Healthcare
  3. Case Management

You're faced with competing insurance claims. How can you ensure your client gets the care they need on time?

When faced with competing insurance claims, proactive case management is essential to ensure your client receives the care they need without delay. Here’s how you can streamline the process:

  • Document thoroughly: Keep detailed records of all communications, treatments, and claims to support your client's case.

  • Communicate proactively: Regularly update all parties involved, including insurers and healthcare providers, to maintain transparency.

  • Advocate assertively: Push for expedited reviews and decisions from insurance companies to avoid delays in care.

How do you handle competing insurance claims in your practice? Share your strategies.

Case Management Case Management

Case Management

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Last updated on Feb 19, 2025
  1. All
  2. Healthcare
  3. Case Management

You're faced with competing insurance claims. How can you ensure your client gets the care they need on time?

When faced with competing insurance claims, proactive case management is essential to ensure your client receives the care they need without delay. Here’s how you can streamline the process:

  • Document thoroughly: Keep detailed records of all communications, treatments, and claims to support your client's case.

  • Communicate proactively: Regularly update all parties involved, including insurers and healthcare providers, to maintain transparency.

  • Advocate assertively: Push for expedited reviews and decisions from insurance companies to avoid delays in care.

How do you handle competing insurance claims in your practice? Share your strategies.

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8 answers
  • Contributor profile photo
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    Prachi Bhatnagar

    International contracts, Contract Management,Legal Agreements, Contract Lawyer

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    As a lawyer my clients requirements and comfort is my priority. I make sure that all the required documents are in place to avoid rejection and wasteage of time. If my papers are perfectly arranged and submitted process is half done .Delayed processes have factors involved like incomplete and submission of wrong papers .If you are perfect in your work client understands the efforts done by you .Empathy is next most important thing one has to consider becaise if client has lost something he needs lot of empathy that if its not corrected atleast can be claimed for damages caused h. Thirdly keeping client informed of progress is of utmost importance to build good rapport.

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    Quita McNellie

    Associate's degree at Cuesta College

    (edited)
    • Report contribution

    Teach patients & their loved ones to advocate for themselves. Get 2nd opinions. I have been a nurse for 26 years. 5 yrs ago, My husband was in a mountain bike accident & developed a mass on his chest. He was febrile, in pain & the mass grew every day. I took him to 12 appts in 10 days, 8 were in the ER. We were repeatedly told he had a hematoma. He ultimately presented with a hemo-pneumothorax & JVD. I called an ambulance, they released him from the ER in 5 hrs. Dx atelactisis. Finally I called a Surgeon I knew, who met us at the ER. My husband had 80cc of pus removed from his abscess & was admitted to the ICU for 13 days. He was septic & losing kidney function. He had 2 surgeries. Our insurance said it was a pre existing condition.

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    Melissa Cox-Pasqua

    Founder and Director - The Empowerment Group, LLC

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    I have found insuring accuracy is key! Accuracy for the insurance requirements for example, knowledge of what each insurance requires, the timelines and modalities required for specific insurances. Defined signs and symptoms supporting clients diagnosis and level of care; are very effective.

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    Faezeh Elahi

    Social welfare planner,researcher,lecturer

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    Competing insurance claims create unclear services and require reviewing the claims,identify and determine overlaps,evaluate involved parties of insurance and their undertake activities and performance,negative delays and effects,provide detailed lists and following up outstanding information,reviewing the ongoing need for this information and inform them for being responsive about the quality and timeliness of their perform and it needs to acknowledge the rules and client’s rights.Open communication &interview with clients to gather reasonable information about their access and accessibility to insurance,enhance their awareness about their rights and advocate them &evaluate their satisfaction and clarify situation to reach a resolution.

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    Rodrego Way , LPC, LCDC,

    Certified Clinical Trauma Professional and Certified Clinical Trauma Specialist in Sex Trafficking

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    It is my practice to make sure that I provide appropriate diagnosis and assessments in a timely manner for billing insurance. I also make sure that my procedure codes reflect the type of services that I am providing. These have been key factors in helping me provide my clients with consistent successful claims. I also make it a habit of doing notes as early as possible.

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    Keshia K.

    Masters Level Therapist. Case Manager LCSW, C-DBT, CCTP. Clinically licensed in Indiana and Illinois

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    I’m sure to always document symptoms clearly to truly reflect improvements or worsening symptoms. I think it’s very important to maintain accurate and detailed information yet regard the clients perception. Such as “interpersonal conflict with significant other and alleged infidelity” opposed to every detail and names. I do this so if I’m asked to testify in court related to the client there’s enough documentation to competently recall sessions yet less liability in the event any reported information was not accurate. It’s important to understand the criteria for diagnoses and insurance claims to ensure claims will not be denied and cause undue emotional and/or financial hardship to the client.

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    Shelly Davis

    Registered Nurse retired

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    I would be an advocate for the clients needs and interest. I’d review both policies and lean towards the one that is beneficial for the clients.

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    Mariela Haan

    Chief Medical Officer at EPIC Health Solution (formerly known as Ardent Assistance)

    • Report contribution

    Your text is understandable but could be improved for clarity and flow. Here's a refined version: > We always communicate with all parties to facilitate the process for the companies involved while also alleviating the burden on the insured and their family members during these vulnerable times. Our priority is the insured—keeping them updated as the case progresses and ensuring that all necessary documentation is obtained in a timely manner so that adjudication can be completed promptly, because for us the priority is for the client to have a good experience despite the circumstances.

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