In All Blog Posts, Long Term Care Insurance

The Growth and Challenges of Home Health Care Agencies Part 2

Part 2: Ways your agency can be prepared for challenges of LTCi

If you’ve read Part 1 of our post on the challenges of home health care agencies, you know that there are many opportunities for growth in the long-term care insurance.

But despite the opportunity that LTCi coverage presents, you need to be prepared for the challenges it brings. The good news is there are several steps you can take to be prepared that will allow you to market to and serve LTCi clients with confidence.

Despite the opportunity that LTCi coverage presents, you need to be prepared for the challenges.

Be Prepared

Instead of thinking of the challenges of working with insurers as a problem, view them as an opportunity to distinguish yourself from your competitors. A few things that you should invest in if LTCi is in your future:

1. Make sure you understand each LTCi policy and its benefits

Most LTCi policies are individually based and not as highly regulated as other insurance consumers are used to, such as life, auto, and health. As a result, there is a wide amount of variance in policy benefits both among carriers and even within individual carriers. Make sure that your staff understands the specifics of each client’s policy benefits, as well as their usage of benefits to date. Many agencies count on the client or their family to deal with the carriers directly, but if there is an issue, it may result in delays in payment to your agency.

2. Know how to bill LTCi carriers

Unlike health insurance, which has standard billing forms, each LTCi carrier has variations in how they will accept bills and supporting documentation. You can help your clients significantly, if you know how to provide the appropriate documentation for each carrier.

3. Be prepared to help your customers

If your agency is prepared to help your customers navigate their policy, the benefits, and the reimbursement, this will put them more at ease working with your agency and may make the difference in you getting their business.

4. Have adequate cash flow

One challenge an agency may have is that it can take up to 75 days to receive payment from LTCi carriers, and you may end up paying $1,400-$2,000 in caregiver expenses prior to being reimbursed. Being able to manage your cash flow can improve the odds LTCi clients will select your agency for their service. The average duration of service for clients is 12-18 months, so the lifetime value of taking these clients is in your favor.


Market your new skills as a strategic advantage

Once you have developed the ability to navigate carriers, benefits, billing, and cash flow from third parties, you should leverage those messages to your referral partners. Your agency can become a preferred care provider for those with third party LTCi coverage. If your agency can develop these LTCi management skills, it can achieve lasting client growth and satisfaction over the next decade.

Jim is a career health care executive with a focus on developing and growing health care markets and services. He has spent over 20 years working in the insurance industry. Jim is the CEO of PayRight Health Solutions, LLC, a technology company focused on improving payment education and management for home care and health care providers.

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