In working with insurers who have established legal bill review (LBR) programs, one thing comes across loud and clear. And that is the inordinate amount of time it took in the initial stages of their program to handle appeals.
While appeals should lessen with time as a LBR program matures and panel attorneys settle into the process, there is a learning curve to get to that point. To get you to that point, here are some points to consider.
Initially, attorneys will test you.
Initially, attorneys want to know just how stringently an insurer will apply its billing rules. They can be expected to appeal many deductions to see if a company is really, really serious about enforcing its guidelines. This is especially the case in situations where the insurer has been very lax in the past in enforcing any billing guidelines. Thus, the amount of time initially needed to handle attorney appeals can be both overwhelming and unanticipated.
It does not have to be that way.
How to cut down on the number of appeals and, more importantly, the time it takes to handle appeals? A company could simply not take as many deductions or phase in difference parts of their billing guidelines, but that would just cut down on the potential cost savings.
The preferable way to reduce initial attorney appeals is to spend more effort up front educating attorneys on what will be deducted and why. Sending out FAQs or alerting attorneys to “points of emphasis” in how legal bills are reviewed will help all attorneys better understand up front what they need to do in order to align their billing procedures with company requirements.
Expend “effort,” not “time.”
Notice I said “effort” and not “time.” This is because the information to be provided can be both electronic and broad based.
It all starts with litigation and billing guidelines that provide enough information to attorneys on what the company will and will not accept. Companies that prefer simplicity in their billing guidelines are missing an important opportunity to inform attorneys up front just how the company will review specific entries in legal bills. This is definitely an area where more, not less information is important. (Not sure if your litigation and billing guidelines are up to date? See my December 9 post on updating your litigation and billing guidelines.)
Provide as much information as possible on any deductions.
E-billing programs have drop down menus for selecting certain reasons for deductions and there is space for making comments. Care should be taken to work with the e-billing vendor to make sure that the selected reasons are not too brief as to not be communicative enough. But, do not overly rely upon using the drop down menu. Try to take an extra few seconds and put sufficient information in the comment box to make sure the attorney fully understands why you are taking a reduction.
It is just as important when not using an e-billing program to also take an extra few seconds to provide sufficiently informative comments to support the reasons for any deductions as this should pay off in less appeals. Again, it is important to remember that providing more, not less information is the key to reducing attorney appeals.
Please contact me if you need more tips on how to reduce appeals of legal bill deductions. Also contact me if you would like information on how to start an in-house legal bill review program or to schedule a training session on legal bill review for your staff.