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Bill Direct legally

Enlighten me! If you do not have a contract with the network and bill directly to the insurance company.. then a network turns around and tells you it must go thru the network and you still refuse... or the network mails a payment that is less than your invoice.. what is lawful here? What legal rights do we have as far as holding the insurance company liable for payment in full (if invoice is fair and reasonable) and denying to work with the network?
Don't we have any legal rights to hold the insurance companies accountable for payment of claims and not forcing us to use the networks?
Hard to put this into words!

Re: Bill Direct legally

Call NEON

Re: Bill Direct legally

All you glass shops that are billing directly and receiving payments from a network and not going thru a place like NEON:

What are you doing with the short pays?
Isn't there something legally we should be able to do to be able to bill directly to the insurance company?
What are the laws on this subject?

Re: Bill Direct legally

Never been short paid in 7 years.

Re: Bill Direct legally

Glassdog,
Don't tell me you have never been short paid in 7 years by an insurance company. One of two things are happening, either you are billing at ridiculously low rates or you are billing the insured the difference. What do you do when Progressive pays you a substantial percentage off of NAGS, I know they are not paying your invoices in full?

Re: Bill Direct legally

never once, fact.

Re: Bill Direct legally

glassgod, does that have anything to do with the possiblity that you are from minnesota?

i wish the national glass association's could get results similiar to the ones the glass association in minnesota were able to achieve.

Re: Bill Direct legally

We are in Milwaukee, Wis. area. I am not saying we are at all happy with what we are paid for insurance work, I just pay attention to details and bill what is allowed, or if that is not enough, turn down the job. Luckily insurance is about 8% of our jobs.

Re: Bill Direct legally

If I have learned one thing in this business, it is that you have to stick up for yourself because no one else will.

As Johnny Cash said, "this world is rough and if a man's gonna make it he's gotta be tough." (No slight indended to the gals out there).

I am preparing to take just about every insurance company to court to fight for my prices. I have found an attorney that will do it for a percentage as long as I have enough $$ to go after.

NEON is another route to go, I think they are doing a great service for our industry.

And who made a law that says you can't bill direct? Legality has nothing to do with it, unless you signed a contract with someone agreeing to use their network.

Re: Bill Direct legally

Bingo John.

Welcome to the daylight.

It's quite warm and sunny out here and there's more of us out here than some would like you to believe.

Re: Bill Direct legally

When ins co's and tpa's FORCE us to use the tpa's, and they dictate the price or we don't get the job ,, how is this not "RESTRICTION OF TRADE". Why is it that noone is calling them on this? Wouldn't it be possible for enough ind. shops to start a combined effort or class action to stop this? hmm I don't get it,, what am I missing? I think every shop out there has enough proof to prove that thier business is being restricted by sgc, lynx, ect. ect. Not only in access to OUR customers, who want to use us but also in pricing we are forced to accept or they steer the customer away. I think it's going to take a great legal team and some independent shops with deep enough pockets to get the ball rolling, but even us little guys I believe would join in!

Re: Bill Direct legally

Simply put, CS, they are hiding behind the illusion that what they do is good for consumers because it holds prices down, therefore keeps insurance rates from going up. Good for insurers is good for consumers and it supposedly trickles back to consumers.

Of course, some of us know that no one is checking what the consumer is actually receiving for this supposedly lower dollar, and that the insurers are the ones benefiting with higher profit margins and lower loss ratios as a result, with no proof that one thin dime is passed back to insureds, let alone that no one is checking to see that quality work is being done. (please don't anybody say that Metryx will solve this issue, I'll toss my waffles)

That's how they get away with it. Or at least how they have been getting away with it.

Right now, with another record setting profit year by prop and cas insurers despite Katrina and Rita, and with insurers demanding yet and still another round of rate hikes, it's getting very hard for them to hide the facts.

Facts like how 2005, a record profit year despite the two worst natural disasters in history ($ wise) was up some 18% over 2004, another major record setting year despite not two, but four hurricanes. Facts like how spokespeople for the insurance industry are calling the record profits a "fluke" while asking for rate increases, facts like Allstate's Liddy lobbying on capitol hill for the government to implement a natural disaster backstop funded by taxpayers for insurers, again....despite record profits in the face of these disasters causing record payouts for insurers. Facts like how profits would have been even higher if insurers hadn't increased reserves another 7%, that's another $25-30 Billion that does not show up in the already staggering profit figures.

Consumers are easily imagining what insurers profits would have been, without the catastrophes, and when they see their premium notices, just aren't happy campers.

But, Hey, don't take my word for it:
http://www.post-gazette.com/pg/06099/680400-28.stm

Re: Bill Direct legally

Well something has to happen eventually. The insurance companies keep making huge profits and we pay them more for insurance on our own Auto and Homes, ect. every year. The rates keep going up yet they want to pay out less and less on any type of claim. The doctor's and dentist are slowly giving up on billing insurance companies. Notice that most make you sign a nice letter that if they get short pay than you the insured will have to pay the remainder. Even a lot of eye doctors won't bill an insurance company. Their control is so sad. Between the insurance companies and the TPA's they are just killing our country and I am just plain ill about it really. I don't know what the government is getting out of it. blah blah blah

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