Third-party administrators (TPAs), direct billing, etc.—pretty much anything related to insurance is always a hot topic, and this was the case when AGRR magazine surveyed its readers to see how the large TPAs and insurers stack up. Participants were asked questions related to efficiency, fairness and general ease in working with them. (For the full article, look to the upcoming January-February issue of AGRR magazine, which also includes a feature article about direct billing. This is all part of AGRR’s special series on getting paid.)
Here, AGRR shares some comments from survey respondents on the topic of TPAs, direct billing and network pricing. Perhaps it will help you in your business as your navigate through the insurance process in an effort to get paid.
“We have been direct billing all insurance companies since December 2013,” says one survey respondent. “Now, four years later, we have established agreements with several companies and still run into short-pays out of the usual suspects, most of which go directly to suit.”
While direct billing does work for some glass shops, others have been frustrated by the game-playing and the presence of the middleman.
“There should not be any middleman steering our services,” says one respondent.
“I’m a very small business and after 15 years of playing the games with insurance companies, I decided to not bill them anymore,” adds another. “I have my customers submit the bills.”
Sadly, some companies have almost given up altogether.
“I almost stopped putting in glass because of TPAs,” says one respondent.
Many others continue to serve the customer with their auto glass needs, but they have done so without being able to raise prices, even as the work has become more complex. And many blame that on Benchmark Pricing.
“Benchmark pricing is the worst thing to happen to glass shops … It’s time to direct bill insurance companies a fair and reasonable price again.”
Another says their shop hasn’t been able to raise prices since the ‘re-alignment’ for pricing back in 2004.”
“All I ever get from the third-party TPA is a larger discount or less dollars per hour on labor,” says this respondent. “The TPAs say it is the insurers, and the insurers say it is the TPA, and I am the one who loses out on any profit. I do twice as many windshield as I used to for half the money.”
Others who have stayed in the business have cut out the insurance company almost completely.
“We do very little insurance work anymore due to the fact that TPAs have removed all the profit from it,” said one respondent. “We now mostly perform work for our loyal customers and walk-in over-the-counter cash customers. If one of our customers wants to use insurance, we have them pay us and submit their bill to their insurance company.”