January, 2019 |

Gut Check Time! Do You Trust Yours?

January 30, 2019 Mark Hammerstrom

“Whenever you see a successful business, someone once made a courageous decision.”

? Peter F. Drucker

“The straight line, a respectable optical illusion which ruins many a man.” ? Victor Hugo, Les Misérables

We have become a data driven world. Today decisions, especially those which are high risk, are increasingly based on ‘what the numbers tell us.’ Perhaps rightly so. We get so much input from so many sources that it is hard to simply sort it all out in our heads.

Data drives just about every business these days; even in sports this trend is obvious. Baseball has its “sabermetrics.” So does football in its own way. In fact, just look at the number of teams using tablets on the sidelines, instead of paper, to get a better sense of what is happening on the field and make faster decisions.

Yet, hardly a Sunday goes by when I don’t hear one analyst or another say: “What they are doing is just not working…time for the (offense/defense—take your pick) to do a ‘gut check!’

A gut check. That seems like kind of a quaint idea in this world of data, but how often have you felt your innards tighten up, perhaps your pulse rate increase and just have that sense that this is not the right decision even when all the data says it should be?

Writing in The Washington Post, reporter Ana Swanson reports on a new study which lends credibility to the belief that our ‘gut reactions’ can in fact be highly important factors in decision making. In her article titled “Why gut feelings may really help you make risky decisions” she discusses a new paper on the subject published in “Scientific Reports”. She reports that “These feelings, which result not just from a person’s gut but also their heart, lungs, bladder, bowels, skin and other organs, aren’t just random. They contain signals that tell people about their emotional states, including pain, anxiety and doubt, the researchers say. And some people are better at detecting these signals than others.”

The research was done in part by John Coates, a former derivatives trader in the financial services industry, who now does work as a neuroscientist. He focused his research on a set of financial futures traders and a set of non-traders. Although the study size was small “…it supports a larger body of research suggesting that subtle physiological changes can aid people in making tough decisions.”

The long and short of the study was that the two groups were asked to count their heartbeats without directly feeling their pulse (read: listening to their gut). The results showed that “…the traders were significantly better on average at counting than non-traders. The researchers also found that traders’ precision on counting their own heartbeats predicted their profit and loss record, and the number of years they had survived in the market.”

While data is critical to success these days, it does not have courage. It does not have sensitivity. It has no appetite for risk; or, as a balance to risk, common sense. So, there is still a place in this fast paced, fact and data driven world for doing what our ‘guts’ tell us.

Why is this important to us at A. Alliance Collection Agency? Because we still use our ‘guts.’ To be sure, data drives our business, too, but a debt is a debt that must be paid and we are highly tenacious when it comes to recovering a debt on behalf of our clients. Yet, we pride ourselves on a ‘compassionate approach’ to collecting, at least in the initial stages of the process. We realize that debtors are people too and often a ‘gut feeling’ can produce better results using a compassionate approach rather than a heavy handed one right out of the gate. The benefit to our clients is that we maintain a relationship with the debtor, and we are keenly aware that how we represent them reflects on them as well. At A. Alliance relationships are key and a good ‘gut check’ can maintain them and improve our client’s results.

A. Alliance Collection Agency, Inc. is a full service, licensed accounts receivable management and debt collection agency providing highly effective, customized one on one management and recovery solutions for our business partners. Founded in northern Illinois in 2005, we have been proudly improving the bottom-line on behalf of our business partners in and around Chicagoland for over 14 years.

Random Acts of Kindness to the Rescue

January 24, 2019 Lisa Brammer

Is it just me or have you also noticed there are a lot of angry people out there? Everywhere I turn I hear and see people focusing on what’s wrong with the world, ranting about one thing or another. To make matters worse, I’ve recently noticed that I’m ranting about their rants! All this anger is making me angry.

I find it tremendously sad and disconcerting that feeling angry is so contagious. Luckily, do you know what else is very contagious? Random acts of kindness and feeling good.

I recently read an article in the Insider that talked about ten different people and their random acts of kindness that have gone viral on the internet. One of the stories was about a guy, Mark Chalifoux, who was accidentally added to a chat group that was talking about sending care packages to a family member serving overseas. Instead of ignoring the chat or replying wrong number he got involved and started a GoFundMe page to raise money to buy cookies for this serviceman and others in the unit. His genuine lighthearted gesture gained momentum and was promoted by celebrities on social media and picked up by news outlets. He ended up raising enough money to not only send 40 pounds of cookies, but also a second shipment containing nutritious snacks and toiletries to the soldiers.

Reading the ten stories not only bolstered my faith in humanity, but also my mood. I found myself craving more, so I did a Google search. Do you know what I found? There are lots of RAKs (Random Acts of Kindness) out there! There was even an article in Reader’s Digest about RAKs that changed people’s lives. And an organization that exists solely to promote RAK: Randomactsofkindess.org There is also a Random Acts of Kindness Day. This year it is on February 17th.

The thing is, anyone can perform random acts of kindness. And they don’t have to be life-changing to make a difference. I remember back in my early 20s when a coworker paid me a spontaneous superfluous compliment. It was such a little thing, but I remember how it made my day. It had such impact on me I’ve tried to pay it forward and compliment at least one person every day. And even though I haven’t been very good at doing it every single day, I’ve found that I get as much out of giving the compliment as the person gets by receiving it. Isn’t that a wonderful phenomenon?! So instead of focusing on what’s wrong with the world, maybe together we can make this world a better place to live—one random act of kindness at a time.

Health Insurance Claim Denied? Now What?

January 16, 2019 Lisa Brammer

We pay a lot for our health insurance, too much if you ask me. So when we end up sick or injured and actually have to use it, nothing’s more frustrating than seeing a denial come through the mail. Am I right?

I read in a 2017 study by HFMA (Healthcare Financial Management Association) that $262 billion in medical (read hospital) claims were initially denied in 2016. Another study by (Government Account Office) GAO, found the rate of denials varied significantly across insurance providers—from 6 to a whopping 40 percent.

The silver lining? The HFMA study also reported that 63 percent of the claims initially denied were eventually paid. My family members and I have been the recipient of many, many medical insurance claim denials. Luckily, we’ve been able to get most of them paid. And if you follow some of these tips you should be able to get some of yours paid too.

First and foremost: Read your policy. A lot of problems (read denials) can be avoided when you understand what’s covered and what’s not.

Sometimes you think a procedure will be covered, but find in the fine print it is excluded. Finding this out before the procedure, especially if it’s an elective surgery, could save you from a big financial nightmare.
Is there a network that you must stay within? Using an out-of-network provider or facility can result in a denial or a reduction in benefit at the very least. Just because the doctor is in the network doesn’t mean the facility he is using for your procedure is. Always check ahead of time.
Does your plan require a referral or pre-authorization? Diagnostic tests like MRIs and CT scans often require pre-authorization from you insurance company. Be your own advocate: ask the doctor ordering the test if they are going to be taking care of the pre-auth or obtaining the referral on your behalf. Don’t assume they are going to or you might end up being responsible for the bill.

Did they send the bill to the wrong insurance company? Did your insurance change since the last time you saw this doctor? Make sure the bill went to the correct company. Sometimes families have coverage from two different policies. If that’s the case then coordination of benefits (COB) could be the problem. Depending on the circumstances, errors can occur when determining which insurance is primary vs secondary.

Transcription errors are often the culprit. Make sure names are spelled correctly and all important data like dates of birth are correct. Typos happen more often than you think. Those claim can easily be fixed and resubmitted for payment.

The reasons for some denials aren’t as easy to identify or rectify as others. Don’t hesitate to call your insurance company (the customer service number is on the back of your insurance card or listed on your denial letter or EOB) or your medical provider if you don’t understand the reason for the denial listed on your Explanation of Benefits. Sometimes there are diagnosis or procedure coding issues, insufficient medical necessity or timely filing issues.

The two most important things to do when inquiring about a denial is to keep calm (emotions can run high during these circumstances!) and take lots of notes. Always ask for the name and title of the person you are talking to and jot down the time and date of the phone call. Before hanging up ask if there is a reference number associated with the conversation and be sure to write that down as well. There was a time when my son was having a procedure and I called both the insurance company and the surgery center prior to the procedure to verify it was in-network since I couldn’t find it listed. Afterwards, insurance denied the claim saying the facility was out-of-network. It turned out the surgery center did not become an in-network facility until one week after his procedure. Since I was able to provide the name of the person I spoke with, date and time of the call, along with the reference number provided during the conversation the insurance company paid the claim at the in-network rate.

If you don’t understand the reason for the denial ask questions until you do. Then if you still think the claim should be paid gather the necessary evidence you might need to get the claim paid: including referrals, prescriptions, or other relevant information. Also speak with your provider. They want the claim paid as badly as you do. See if there is anything you can provide to help with the appeal process.

Remember, appealing a denied claim takes time. It’s important if you are working it out on your own to let the provider know what’s going on. If you call them and tell them you are working with your insurance company trying to get it paid, they will oftentimes put the account on a hold, meaning they will not send it off to a collection agency. These holds do not last forever so continual communication is a must if you want your account to stay in good standing.

The important thing to remember is just because a claim is denied doesn’t me you can’t get it paid and the three most important things you can do to move forward is communicate, communicate, communicate.