One of the most utilized services offered by the GLMS Physician Education and Practice Support Department is Hassle Reporting, where providers can report ongoing insurance issues to GLMS. We work with the payers daily and track issues to identify trends. On average, hassle reports that were resolved have resulted in savings of approximately $2,600 for each physician case.
Since 1998, GLMS has fostered and developed relationships with the insurance payers to ensure member hassles are addressed expediently. The Hassle Report Form, (originally named the Hassle Factor Log) is a steady and growing part of the Society’s functions and is a member benefit that provides a substantial ROI for our members. The communication channels and relationships made between the GLMS PEPS department and the representatives at each insurance company throughout the years are critical to GLMS’ success in assisting with insurance-related issues.
- In order to submit a Hassle Report Form, practices must have a Business Associate Agreement (BAA) on file with GLMS. A blank GLMS BAA may be downloaded here.
- Is your hassle specific to increased hold times with a payer? Click here to download a Hold Time Tracking Form
- Is the hassle with a Kentucky Medicaid MCO? In addition to submitting a hassle to GLMS, also complete the Medicaid MCO Provider Complaint Form
File a complaint with the KY Dept of Insurance
Consumer Complaint: (for private health insurance, life, auto, home, general liability) A consumer complaint is filed by a consumer, or their representative, who is having difficulty settling a situation with an insurance company, agent, or adjuster. To file a consumer complaint online, click here.(ConsComplaintWithInstr052019.pdf (ky.gov)
Clean Claims: If you are a medical provider and want to file a CLAIM SPECIFIC complaint against a health insurance company, click here. (Clean Claim Complaint form Rev 10 01.PDF (ky.gov)
Over the years, reported hassles have involved inappropriate bundling of services, nonpayment for certain medications/vaccines or procedures, unreasonable pre-certification procedures, long hold times, incorrectly denied claims, policy issues, improper payer notifications and lack of payer response or follow-up. Frequently, these complaints are not isolated but are found to be a common trend experienced by multiple physician practices regarding the same carrier. For this reason, it is imperative that practices notify GLMS of existing problems so that they may be resolved with the insurance carrier. The execution of the solutions to these problems is followed up by the GLMS staff on a daily basis.