What does your claim rejection message really mean?

By Janice Salmon, JustPressOne

Does this scenario sound familiar?    

Recording: Your wait time is 12 minutes, please hold for the next available operator.
Vendor (16 min later): Good morning, this is Katie, can I help you?
Servicer: Hi Katie, this is Janice from XYZ Appliance. My claim, No. 12345, was rejected for ‘Commercial application — no labor warranty applies,’ but the unit was in my customer’s home, not a business.
Vendor: Can you give me the model number?
Servicer:  Sure, the model number is TR4005.
Vendor: This is a residential unit, not sure why your claim was rejected.  Let me transfer you to the warranty department.
Vendor (10 min later): Hi, this is the warranty department, how can I help you?
Servicer: The previous department confirmed that I have residential unit, model TR4005, that was incorrectly rejected for ‘Commercial application — no labor warranty applies.’ Can you please fix my rejected claim, No. 12345?
Vendor: Your serial number is registered to a commercial unit, not the TR4005. Can you please check the tag for the correct serial number?
Servicer: Then why didn’t the error message say that the serial number isn’t valid on that model?
Total Time:  45 minutes

This is a typical conversation about a rejected claim in which the error message to the user is confusing or misleading. If you file 100 warranty claims a month, 20% will be rejected and 10% of those will require a phone call to the manufacturer. Ten claims at 45 minutes per claim means that the equivalent of one eight-hour workday will be spent on those 10 claims every month.  

Unfortunately, there is no standard for warranty claim rejection descriptions. Therefore, we have to read between the lines to understand what each manufacturer’s error message means: 

spCreateRepInfo Error: Have you received this error message yet?  Sounds to me like the error message is an error!  

Refile Listing Part Info to be Paid Also: For this error message, the manufacturer is saying a part needs to be added to your claim. The Service Performed verbiage included in the claim led the manufacturer’s processing system to believe a part was required. So maybe the correction doesn’t require adding a part, but rewording the Service Performed details. Could be that you want Labor Only; either way it requires an investigation on your part and possibly a call to the manufacturer.

Authorization/Call # Not On File: When a job in warranty is sent to you by the manufacturer, you receive a dispatch or call number in advance, which needs to be in the claim data when submitted. So what does this error message mean?  If you were dispatched the job with the call number assigned, how can it not be on file? Another call to the manufacturer.

Must Select Repair Level of ‘Parts Only’:  This is another very strange error message that you can receive when you just submitted a claim for parts only. What is a “repair level”? Another call to the manufacturer.

Proper wording of the customer complaint and Service Performed are crucial to your claims being processed smoothly. Remember, less is more on warranty invoices.

Janice Salmon is the founder and CEO of JustPressOne, a business process outsourcing company and AVB partner that provides claims administration services for independent servicers and self-servicing dealers in the home appliance industry. For more information visit JustPressOne.com.

Upcoming Events