How Many Calls... should schedulers and auditors make to schedule an appointment?

December 2019

It has come to our attention that there is some confusion about how many times a Scheduler should attempt to contact Insureds in order to set appointments or to arrange for records (in the case of Virtual Audits). The basis for the confusion may be a mixture of multiple policies shown below:

How many calls to make to the Insured to schedule appointments/ make arrangements for records as with Virtual Audits? -- NOT TO BE CONFUSED WITH A SEPARATE POLICY --

How many calls are necessary to submit the audit as Non-Productive?

In order to schedule appointments or to make arrangements for records (Virtual Audits), Schedulers must:

Make first call:

- within 15 days of receipt of job, or

upon expiration date of policy (or upon cancellation date)

- Make multiple calls per week (Scheduler/Auditor should only wait a couple of days between calls to the Insured) until the Insured is reached and appointments or arrangements for records can be made.

- All calls and emails should be noted in Progress Notes, along with names, phone numbers, email addresses.

- Schedulers should be professional, courteous, but be diligent and focused on the task at hand: GETTING AN APPOINTMENT OR RECORDS.

- After 3 calls with no answer/no response to/from Insured, schedulers are to contact the Agent and/or send 10-Day Letter.

- When contacting the Agent, give the Agent one week in order to contact the Insured, before calling Agent again.

10-Day Letters

10-Day Letters are to be used as a tool in order to get the audit underway. They are to be used BEFORE the audit is even close to being late. It is to get the attention of the insured when they have not been responsive or willing to proceed with the audit. Use this tool proactively!

If calls, emails, contacting the Agent and/or 10-Day letter has not worked in securing the audit appointment (or in obtaining records for a Virtual), the Auditor/Scheduler should follow the instructions below so that the audit is qualified to be returned as Non-Productive. Timeliness is essential! Follow the instructions below, use the alert system in Nexus, and stay in contact with your auditor to avoid having the job become delinquent.

- Review Progress Notes and make additional calls/or send additional email that will satisfy the Non-Pro minimum requirement of at least 1 call (or email) per week for 3 weeks. If this hasn't happened, do it asap.

- Use the Nexus Alert System that will send you reminders to stay on track and not fall behind. (Don't know how to use Nexus Alerts? Contact Melinda)

- If still no appointment can be made (no records received), write up the audit as non-productive (contact your auditor).

In summary, calling the Insured multiple times per week and staying on top of the calls often will prevent the need for the 10-Day Letter. Used appropriately, the 10-Day Letter may jump start the insured into action and prevent the need to submit the audit as Non-Productive. However, be clear that the policy of "3 Calls One Week Apart to Insured / 2 Calls to Agent" is ONLY A MINIMUM REQUIREMENT in order to submit the audit as Non-Productive audit and should NOT BE CONSIDERED A SCHEDULING POLICY/PROCEDURE OTHERWISE.

Should you have any questions or concerns, please do not hesitate to contact Melinda Walter.