The Chain of Custody game show is alive and well despite the new age of transparency sweeping throughout the government controlled American health insurance industry.
We were reminded of this yesterday when an underwriter called: “Bill, I got this case from someone else. The data you sent is different. The claim information doesn’t match!”
“Really?” I responded. “We got the data from the group who got it from their broker, a well respected national brokerage Who sent you the information?”
“We got it from the current TPA and their information looks much better than yours” said our underwriter, a friend of many years (He loves doing business with us because every case we have placed with him over the years has been profitable).
Its obvious the broker, a nationally recognized and well respected brokerage is playing the Chain of Custody game, doctoring and/or omitting crucial claim information in order to gain a competitive edge.
Plan sponsors should always ask for their claim data directly from the payer, not their broker. They should also require monthly claims data throughout the plan year rather than wait until they go to bid to request it. Otherwise its a recipe for disaster when seeking competitive alternatives through multiple brokers who are all going to the same markets anyway. It’s best to stick with one broker to shop the market.
In this case the plan sponsor has no clue what’s happening. We learned from past experience that when informing a plan sponsor of the problem they get mad……..at us! They think we are bashing their broker and that kills any chance of earning their trust.
