When a problem payer won't communicate, lean on your colleagues for support. In last month's Medical Office Billing & Collections Alert, you learned about solving payer problems by researching policies, contacting payers, and refiling claims (see "Master the Art of Working With -- Or Around -- Problem Payers" Vol. 9, No. 8). If these tactics don't resolve the issues, move on to these additional tasks. Step 4: Expand Your Research Beyond Your Practice Talk to other practices in your geographical area and within the same specialty. Find out if other practices are having similar issues and, if so, how they are dealing with them. Here's how: • Call the other practices in your area and other practices of the same specialty within your state. "When I see a trend, such as consistent underpays, or invalid POS denials, I will contact other providers in the region to see if they are having the same problems," says Cheryl Nash, director of operations and senior account rep at American Physician Financial Solutions in Colorado Springs. "I have on numerous occasions detected a computer edit issue from an insurance company that can be corrected if you insist enough, and climb high enough, to make the payer investigate." • Check your state medical society's Web site for helpful resources. • Join The Coding Institute's billing listserv at www.coding911.com. Specialty-specific listservs often provide an opportunity to research if others are receiving the same types of denials, delays, or payment reductions. "We are all in this together and need to let the insurance companies know we will not take this laying down," agrees Gaye Pratt, coder/biller for Vincent P. Miraglia, MD, in Stuart, Fla. Step 5: File a Complaint With State Officials If you attempt to resolve issues directly with a payer, but you don't seem to be getting anywhere, your final step should be to enlist the assistance of your state's medical society as well as involve your state's insurance commissioner. Tap the medical society's power: "If I don't receive a satisfactory answer, I inform them that I am sending a letter to the insurance commissionerthat day," Pratt says. Keep in mind: Prolonged issues? If your practice decides to no longer contract with a payer, be sure to check your contract and give the appropriate notice to the payer in terms of method (in writing) and sufficient notice as defined in the contract. Then you want to make sure that you give sufficient notice to your patients. "When the patients complain to the insurance companies, I usually get very quick responses," Pratt adds.