Inaccurate insurance bills are more common than you might think, and they can lead to significant headaches if they aren’t managed properly. So, what actually happens when you get an incorrect insurance bill? Let’s break it down step-by-step.
Step 1: Identify the Inaccuracy
Typically, your client will notice the error and reach out to you for help resolving it. Common issues include being billed for an ineligible employee or seeing an inflated total that doesn’t match your employer client’s records. Pinpointing the mistake is essential so you can start the resolution process.
Step 2: Contact the Carrier
Once you’ve identified the issue, your next step is to contact the insurance carrier. Typically, you will reach out to their client service team on behalf of your client, explain the error, and ask for a correction.
Step 3: Carrier’s Response
Most of the time, the carrier’s response is straightforward but less than ideal—they’ll tell you to have the employer pay the incorrect bill for now, with a promise to adjust it on the next invoice or issue a reimbursement later. While this might address the immediate concern, it adds work on your employer’s end.
Step 4: The Employer Will Make Adjustments on Their End
Until the correction is reflected in their billing, the employer will need to track that overpayment in their accounts payable system, noting the amount and setting reminders to verify that future bills include the promised adjustment.
Step 5: Follow-Up
Unfortunately, billing errors often require more than one call to fix. Following up with the carrier might become necessary if the adjustment isn’t processed as promised, and this process can stretch on for months, consuming time and resources.
One primary reason for insurance bill inaccuracies is a lack of synchronization between eligibility and billing systems.
Here’s how it usually goes wrong:
When an employee leaves your client’s company, or they’re no longer eligible for coverage for another reason, you inform the carrier to terminate their benefits. But while the coverage is ended, the billing department might miss this update, leading to ongoing charges for someone no longer with the company or needing coverage. This disconnect is especially common when eligibility and billing operate on separate systems, leading to errors that frustrate you and your employer clients.
Incorrect billing can create several issues:
BernieBill is an integrated billing solution that keeps your insurance bills accurate by directly connecting eligibility data from your BerniePortal benefits administration system to billing.
Here’s how it works: When an employee’s eligibility changes—whether they’re added or removed from coverage—BernieBill updates in real time, so your bill is always correct. This eliminates the need to manually update information, make follow-up calls, or manage separate systems. Your employer clients will no longer pay for ineligible employees or deal with surprise charges, and you’ll save yourself the hassle of tracking adjustments or worrying about costly errors. And– we’ll never ask you to pay an inaccurate bill.
With BernieBill, you can trust that your insurance bills automatically reflect the latest eligibility data. It’s an easy, efficient way to prevent billing headaches for you and your clients—ensuring accurate bills every time.