How to Get Your Water Restoration Invoice past the Adjuster the First Time.

One of the most frustrating things about water restoration is getting a call from the adjuster saying your invoice is too high. Having been in the business since 1992 I have gotten plenty of calls from adjusters saying that my price is too high on this dehumidifier or this fan, or that a particular line item wasn't needed at all. This used to bug me and really frustrate me until I learned the secret to prevent most of these calls, communicate and document everything. Remember that the adjuster has to justify his work to his boss and as long as the price and scope of work can be justified then it will be paid.

Starting off the job on the right foot is important. You should always get a work authorization signed by the insured before starting work. A work authorization will allow some insurance companies to be able to pay you directly or at least get your name on the check.

Photos should be taken many times during the job. Photos of the loss as it is when you arrived, including pictures of the outside of the loss. Then once you have your equipment set up it is a good idea to take more pictures to verify the equipment you left, show how neat you left the loss, show any furniture you had to move, etc. Then if something changes during the job like adding another piece of equipment take more pictures. When rooms or walls start getting dry then put your meter on the wall and snap a picture to show that it is dry. Remember you can never have too many photos. The more photos you have documenting what you are billing for the better off you will be.

If it is possible to call the adjuster before you start work discuss with him/her what you think needs to be done. During this conversation I am generally trying to make sure that the adjuster and I agree on the scope of work to be done. This is especially important if there is tear out to be done. However, since most of the time you may not know who the adjuster is for a day or two, it is generally acceptable to go ahead and remove things like particle board toekicks under cabinets, mdf baseboard or other materials that are not salvageable even if dried. I would wait to speak with the adjuster though if I thought the kitchen cabinets needed to come out. At this point, usually the adjuster has not been there and so to call and inform him/her what is going on is my main objective.

Before you leave the insured's home or office the first day go over with them why you are doing what you are doing. By this, I mean to tell them why you have the fans all going the same direction around the room at a 15 -45 degree angle. Tell them that the dehumidifier drain hose needs to stay in the sink or bathtub because it will pull a lot of water. Make sure to get a time to go back the next day to check the job, and get any additional contact information from the insured. Also, suggest to them that they sit down in each room affected with a notepad and write down all the questions they will have for the adjuster when they arrive. Most of the time the adjusters will answer most of the insured's questions without them having to ask them but if all their questions aren't covered by the adjuster then they are prepared. I also like telling the insured to ask about the extra electricity cost of running the equipment, and ask about reimbursement for the time they spent vacuuming out water before I arrived. These are a few of the things people do not think about but may be covered as part of the claim.

Next, you should have an itemized invoice. The invoice should include your company name, address, (so they can send the check) and your Taxpayer Identification Number. Each room that work was performed in should be separate and have measurements down to the nearest inch. Then within each room list each item or piece of equipment. At this point it is good to comment on the items that are most questioned, such as cost of dehumidifiers, number of fans, extraction, etc. Place comments with the items, if your estimating software will let you, justifying why you charge what you do for a dehumidifier or why you had 3 fans in a 6 x 6 room, or why you needed a trailer to haul off trash. Anything that could be questioned comment on it. To me this is one of the most important parts of the invoicing process. Yes, it is time consuming but the adjuster will be able to see the reasoning behind the line item. This alone may prevent most calls.

Next include a copy of the signed work authorization and signed certificate of satisfaction. This not only shows that the customer was satisfied but that they authorized you to do the work. Make sure that your work authorization form includes a section in it that would allow the insurance company to be able to pay you directly. I, personally, had my lawyer look over my form to make sure it was accomplishing what I wanted it to accomplish. I would strongly suggest that you do the same no matter whether you got a generic form from somewhere or you came up with your own form.

Another form that is good to include with you invoice is a dehumidifier calculation sheet. By including this you can show how you arrived at the number of dehumidifiers needed to properly dry the structure. You can place a comment in the invoice with your calculations and then reference the dehumidifier calculation sheet so anyone looking at the file can come up with the same amount of dehumidifiers you used.

Another tool that helps justify your bill to the adjuster is your daily humidity readings. You should be keeping the temperature, relative humidity, and grains (gpp) inside, outside, unaffected area, dehumidifier(s), and the HVAC. By doing this you will be able to learn about what is going on during the job. For example, several years ago we opened up a new refrigerant dehumidifier and took it straight to a job. When we got there and turned it on we started running our pshychrometric readings and discovered that there was a problem with the dehumidifier. It was great to find that out then and not the next day when we would have had a lot of evaporation and no dehumidification. Using the grain readings can also help you prove that the equipment was off, a door was opened that you wanted closed, a window got opened, etc. When this is used correctly then you can prove to the adjuster why you needed an extra day. Also make sure to include plenty of comments to go with your readings to help explain what you saw.

To go along with your daily humidity readings try including a graph from a data logger. Data loggers can be set to record the temperature, relative humidity, grains, and even dew point as often as you would like. I like to set ours to record every minute and this gives you a good graph of what is happening on the job. When the job is complete then print the graph and turn it in with your invoice. Just like with your daily readings a graph will help prove what you saw happening on the job. (i.e. door left open, window open, equipment turned off, etc.) Taking an hour meter reading off your equipment at several points in the job can also help prove when things were not running and should be turned in as part of your documentation.

Recently, we had a drying job where we told the insured that the heater needed to stay on so that the house didn't go below 70 degrees. However, everyday we showed up to check the job the heater would be off. We would turn it back on and remind the insured it needed to be on. This went on for 6 days. Since we were in constant contact with the adjuster we were letting him know what was happening. We also explained that this job is taking a lot longer to dry out than we expected because of the heater always being off. When we got done with the job, I printed the graph from the data logger and was able to prove to the adjuster every time the heater got turned off.

This same job, I also had a discussion with the adjuster about us removing one dehumidifier the last day. I was against this because we had a large air space to dry and even though there was only one wall still wet I still needed to control the grains to get that one wall dry. Even though he approved me using the dehumidifier on the last day I could tell he wasn't totally convinced. Then I remembered one day during the job we had showed up and one dehumidifier had been accidentally unplugged. That day the grains inside where real high. So I was able to show the adjuster on the graph what would have happened if we would have pulled one dehumidifier the last day, by showing him what happened when the dehumidifier got kicked out of the plug earlier in the job. This graph and explanation from me to him helped him go to his boss and say hey this 7 day dry out needs to be paid in full because of these issues and here is the proof. Normally this would have been a 3-4 day dry out but because of these issues it took 7. Since I made the adjusters job easy the invoice was paid in full.

The point is that the more you document the claim to make it easier for people to understand what went on even if they never saw the claim in person then the less trouble you will have with your invoice. The more communication you have with the adjuster, the insured, and any other concerned party then the happier everybody will be with you in the end.

If you really want to separate your company from all the other drying companies in your area then having a great looking claim file full of documentation will do it. Adjusters will love you for making their job easier, and insured's will sing your praises because you kept them informed every step of the way.

Kevin Pearson is a Master Cleaning Technician with The Clean Trust and has been in the cleaning and restoration industry since 1992. Kevin is presently working on a committee to rewrite the carpet inspector standards in our industry and has previously served on the carpet cleaning standards revision committee. He also serves on two other committees at The Clean Trust and is on the Board of Directors there. He also serves on the Board of Directors of the Professional Cleaning and Restoration Alliance. For more information visit us at http://www.prodrying.com/ or http://www.pearsoncarpetcare.com

How to Get Paid Faster from Insurance Companies

Having been in the water restoration business since 1992 I have seen a lot of changes through the years in equipment, pricing, methods, third party vendor programs, etc. One of the biggest changes is the amount of documentation that needs to occur on ever water loss. Unfortunately, you can't charge for it but it needs to happen to protect you if that ever is a problem on a job. Let's look at what it takes paperwork wise to document a claim properly.



First there's the photos. To do it properly, you will need some photos of the outside of the loss, photos of each room affected from the loss, closeup photos of damaged items, photos showing wet structure items with your moisture meter in the photo, photos of your temperature and humidity meter inside, outside, and in front of your dehumidifiers, more photos of all of your equipment set up within the loss, then as walls become dry you will need photos of your meter on the wall showing it is dry. All these photos need to have a date and time stamp. Then when you load these into the invoice you will need to label each photo so that others looking at it will know what it is.



Then there is the forms. You will need a signed Work Authorization from the insured before beginning to work, a daily humidity reading log sheet, a Certificate of Satisfaction signed by the insured when work is completed and a dehumidifier calculation chart to justify why you used the amount of dehumidifiers you did, plus any others that would be pertinent to the claim. Then all these documents have to be scanned into the computer and uploaded to the claim with a detailed description of what each one is.


Next you will need to sketch out the loss. You will need either a hand drawn sketch or do your sketch in one of the many industry software programs that are available. The sketch should show doors, windows, measurements, names of rooms, and origin of loss.

Then there is the notes. If you are doing the paperwork part correctly then you will accumulate lots of notes. These notes will help all the "inside" adjusters that look at your claim file understand why you did certain things, who approved it, etc. The notes will also help them know what is going on with the claim from day to day. These notes should be done daily at minimum and should include when there is contact with the insured, insurance company, or any other interested party. A fully documented claim file, full of notes can really help an adjuster justify your restoration charges, and fully tell the story of what happened to the people that look at the claim only on paper. Notes are vital to a properly documented claim file.




We can now finally get to the invoice. Not only should your invoice contain your charges for the job broken down by room, but it should also have notes after any questionable line item. Say we have a loss in a home where the master bedroom, hall, hall bath, and another bedroom are affected. Then each one of these rooms will need to have the drying equipment that was set in the room during the job, any water extraction, baseboard removal, content manipulation, or whatever else was done in that room. You will need to have notes explaining certain line items. Such as why you charged to haul off a full load of trash or give details as to how you charged for equipment monitoring per day, etc.

The more complete the claim file is the fewer complaints you will have about your invoice and the quicker you will get paid.

http://www.prodrying.com/ or http://www.pearsoncarpetcare.com


Here's the same thing just published on yahoo contributor network. http://voices.yahoo.com/how-paid-faster-insurance-companies-10630047.html?cat=17