This is why it is important to be involved in your overall claims process. There is no rule that states that you have to accept whoever gets assigned to handle your files. Below we discuss a few of the attributes of the proactive adjuster, and why it is important to have this person handle your claims.
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“How Do I Get My Adjusters To Follow My Account Handling Instructions?”
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Proactive adjusters respond to emails within a few hours, if not sooner
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Proactive adjusters return phone calls and voicemails within 24 hours
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Proactive adjusters will handle the medical needs of the file promptly
Reactive adjusters fail to do this. Providers will make multiple calls for authorization or billing information, with no response. Then when the claimant calls to schedule their appointment, they find out that the medical office is still trying to get a hold of the adjuster. This will prompt the claimant to call the adjuster, to find out what the delay is. Failure to respond to those calls will lead the claimant to contact their employer, complaining about why they cannot get the medication or treatment they need so they can get back to work. Before the reactive adjuster knows it, they have 3 separate parties making numerous calls and emails to them on the same issue. This is just not proper behavior. Had the adjuster returned that one phone call to the provider back in the beginning, the rest of the issues and voicemails would have been avoided. Employers have more important things to do than babysit the adjuster that handles their insurance claims.
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Proactive adjusters take the time to explain claim issues to the involved parties
Summary
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