I have spent hours reading a lot of stuff about direct billing vs TPA's. I am one of many who are tired of a particular competitor profiting (very handsomely, when you consider a 6 minute phone call) from the hours of work I do.

I have tried to nail down specifics but it seems they are difficult to find. What I do know is I need to call my state auditor to find out what my rights are and what the process is going to be.

Here's a point on which I'd like clarification:

When a customer requests to bill insurance, do I simply call the claims number and NOT select glass claim, but rather route to the main Ins company and request verification of coverage? Then request a method to direct bill (probably argue a bit with the operator about TPA)?

Here's some questions:

Is canceling my contracts with the TPA's as simple as sending them a fax to that end?

Should I document with photographs the work completed to CYA?

Do I need to enlist an adjuster? I see posts on here about appraisers/adjusters when this topic comes up.

Also, regarding my cash prices: If a dispute is brought to a level of adjudication, is there any sort of investigation done regarding what I charge for payment at time of service or fleet work? And if there is disparity, then what? Do I need to inflate my cash prices some to bring it closer to the NAGS prices? My prices are already higher than most of my competition as it is.

And to conclude, I am frankly happy (most of the time) with what I make from insurance work. What chaps my ass is when I know that the NAGS -38% means that Safelite gets to bill the insurance company that 38% I left on the table for doing nothing other than taking a phone call.

Thanks for any and all assistance.

keep us posted as to how it is working for you. I too experienced the same exact feeling about a month ago. I sent all the Networks a notice of cancellation of agreement and just started direct billing last week. my experience so far thru Progressive was that they still sent my invoice onto Safelite Solutions and did have on note/file that I would not agree to the Nags - 47%....... Duh why would I give them almost half off of a $250 part Dw1582 + little labor and $15 kit? Total was well under $300... how could we ever be profitable in this day and age with that business model? What if I ever had to redo the job I wouldn't even break even if you removed my labor cost and fuel. Absolutely insane. I'd rather go down swinging than lay down like a sheep.

We've been direct billing for 35 years. The only exception is years ago when SF was actually paying a fair price. We sent invoices to Lynx, but never joined the network. With some companies we send the invoice to Safelite because no matter what we do the ins company forwards the invoice to Safelite anyway, and being stubborn slows down our payment. But we go after EVERY short pay, and many companies have given in. It takes time, but if every shop refused to give in things would improve drastically. On the other hand, if shops keep giving in they will be out of business, and Safelite will be in the drivers seat. And pricing will go up.

What part of this county do you operate. Curious about going after short pay difference. I'm in Oregon but have experience in Florida. I'm curious.

What are doing with Farmers Smiley?

Bill and send every invoice of Farmers here! happy late christmas and please let me know when you get your full pay checks!
bwglass@farmersinsurance.com

Smiley they forward the invoices to S/L we never agreed to any pricing so

yes we will go after the short pays in court.