Friday, 7 July 2017

When having a healthcare broker counts

Most of my job is advising clients on which plan suits and then organising forms, renewals and so forth - administration and consultation by and large.

I earn my money when I can sort a problem for them though. Bottom line is that sometimes things go wrong. I recently had a case where a member on a company scheme of mine was having issues getting a claim through. It wasn't declined but rather the insurer had lead the member down a bit of an administrative black hole.

She called me on a Friday morning and outlined the issue. To resolve things here's what I did.

1) Re-assure the member - form the sound of it there was no issue about coverage - this was a bureaucratic problem.

2) Established on my system that the member was set up correctly in terms of underwriting and benefits - a one minute job but time saving as it brings all the data in front of me for discussion with insurer.

3) Clearly messaged call to the insurer - why has the admin loop being created and importantly how do we expedite.

The problem was in part due to the nature of the condition and in part how long the insurance had been with that company. Either way one simple call clarified the situation (to message back the member) and sorted a possible solution.

This leads to step four :

4) Re-assure the member again - outline the rationale for the insurer. We actually had a little joke about their convoluted admin and then I took ownership of resolving things - we need a claim form form the GP but I committed to receive it, pass to the insurer, chase until resolved. A little more work to me but this is an important issue - twenty minutes of work will likely guarantee the renewal of the scheme and my retention of them as a client moving forwards.

I'm happy to still have a great client and they're happy a frustrating problem is resolved with little work for them or the member to do.

That's where I really earn my money.

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