Through the years we have heard from managers and executives that the reimbursement people were not doing the job. They were criticized for working the cases to death, and not accomplishing much; for not working the cases enough; for allowing the collection agency too much time or not allowing them enough time; for not knowing what the attorney is doing, or for spending too much time on the case although it is in the hands of the attorney. Some of the criticism may perhaps be fair, but by and large it is unwarranted, and we strongly disagree with the criticism. But how can we judge whether the reimbursement people are doing the job? Most reimbursement people are diligent, very serious, work very hard, and the job they have is very difficult, and sometimes overwhelming. As soon as they put down one case they are sometimes inundated with about 10 more cases. How can they ever satisfy the management and executive personnel short of collecting 100% of every claim, which, of course, is impossible. Here are some ofthe rules which some of the managers follow:

1. If two letters, a month apart, and a few phone calls have not succeeded, it is time to seek alternatives.
2. If the cases are sent to a collection agency, the terms of collection should be set forth with each batch. Thus, if the case has been in the hands of the agency for two months, or three months, insurance or medicare cases must be returned. If two or three letters are sent to the insurance company, or medicare, and there is no recovery, the collection agency cannot do anything more to collect the claim. Some states do not allow a collection agency even to turn it over to an attorney. And if your submission letter does not state that the case must be returned after 2 or 3 months, the collection agency will claim a fee when you request the return of the file. And they will hold the file until the fee is paid. That impacts on the ability of the attorney to collect the claim, if it is an insurance case or medicare.
3. If the case is an insurance or medicare case, it should be in the hands of an attorney. Some insurers will not pay any attention to a case unless a lawsuit has been started. Collection agencies cannot do that. For medicare cases, the rules are so complex that collection agencies are not equipped. In fact, most attorneys are not familiar with the medicare rules. These insurance and medicare cases should be in the hands of an attorney who specializes in these cases. The reimbursement personnel should be kept informed of developments, and they often are, simply because in most cases additional documents are needed. Until the case is resolved, no documents should be destroyed. Especially, should the telephone logs be available. And the computers should not be purged of case information. Sometimes cases go a long time before resolution. There are numerous contacts between your attorney and insurance company counsel. Most reimbursement personnel do not wish to know all the details. But if they do want to be kept up to date, please tell your attorney, and every contact will be the subject of notice to the reimbursement department. Our experience has been that after the first 20 contacts, the reimbursement department does not want to be bothered. Of course, if it is coming up for trial, or an important motion, the reimbursement department should be notified immediately.

If these rules are followed, the reimbursement people will have maximum control of each case, and be able to make the necessary decision in each case. But criticizing them, without detailed knowledge of what they are going through, is really unnecessary, unless it is perceived that they are not diligent in their job. But if they are diligent, they should be encouraged, and supported.