LET ME FILL THE BLANKS!
Although you will be utilizing several forms of communication, including the telephone and email, a _________remains the most formal and permanent.
DECISION LETTER
Discuss - CALL TO CLAIMANT
While it is a best practice to communicate all initial STD claim denial decisions verbally to the claimant by telephone , there may be administrative practices in place that require claimant telephone contact for only certain STD claim approvals (e.g., claims not involving maternity and simple surgery).While it is a best practice to communicate all initial STD claim denial decisions verbally to the claimant by telephone , there may be administrative practices in place that require claimant telephone contact for only certain STD claim approvals (e.g., claims not involving maternity and simple surgery).
Write so that your readers will understand your intended meaning. Articulate your thoughts so that the average person can understand them.
CLARITY
Your sentences should be complete, not fragmented , and contain a subject, verb, and object.
USE CORRECT GRAMMATICAL STRUCTURE
Since the level of accuracy and professionalism displayed in any letter is a direct representation of your organization, great care must be taken to ensure that the it is written with _______ , _______, and __________
Proper form , Structure , and Technical Accuracy .
WHAT ARE THE 3 TYPES OF APPROVAL LETTERS
PAY AND CLOSE
LIMITED PAYMENT
ONGOING PAYMENT
Short sentences are usually best. Eliminate unnecessary words and repetition. Less is more.
ECONOMY OF WORDS
If your subject is singular, your verb is plural (“He wants an agreement”)agreement”). If your subject is plural, the verb is singular (“They want an agreement”)
EMPLOYE SUBJECT VERB AGREEMENT
The most important outcome of an approval decision: the claimant clearly understands its ______.
CONTENTS
Discuss - Pay and Close
Those approvals for which the recovery is known and/or well established. This often includes maternity and simple surgery claims. The DCM should inform the claimant that they should notify them immediately if the circumstances surrounding the medical condition change.
Write simply. In an effort to impress readers, some writers mistakenly use the latest buzz words or phrases.
AVOID LATEST JARGON
A pronoun is a word that substitutes for a noun. The most common errors involve the use of “I” vs. “ The pronoun “I” is the subject in a sentence (“I need updated medical records.”). Me is the object (“Please send updated medical records to
KNOW THE RIGHT PRONOUNS TO USE
While the decision letter must first achieve technical accuracy, it should also provide a level of _______that results in the perception that the organization (and you as an STD DCM) is going to make the experience as satisfactory as possible.
CUSTOMER SERVICE
Discuss - Limited Payment
This type of approval is completed when there is sufficient medical information to support payment to a certain point in the future. Because the length of recovery is unknown to the DCM, the claim will remain open until additional information that might support the extension of payment is received. If the information is not received within a certain period of time that is clearly communicated in the approval letter, the claim will be closed.
When writing letters, start by stating your information in a condensed form so that it summarizes your points in an easy to understand way.
CAPSULIZE YOUR POINT
These three are the most important words to readers. Make a mistake with one of these and you’ve likely offended the readers.
FOCUS ON CORRECT GENDERS, NAMES AND TITLES
All forms of communication should be used to set appropriate _________. The decision letter can achieve this uniquely, as it will be sent to the claimant very early on in the claim process. This is a time during the life of a claim that the claimant’s expectations can be formed in a way that will facilitate success.
EXPECTATIONS
Discuss - Ongoing Payment
For those STD claims that have an element of complexity (e.g., behavioral health, multiple conditions, etc.), the claimant will receive weekly benefit payments while the DCM monitors the claimant’s functional capacity and ongoing eligibility for benefits.
That means avoiding unnecessary enthusiasm or exclamation points. Before you complete your writing project, consider how others will view it, as though it might appear in a newspaper or public agency record. And remember, the Internet is forever.
PROFESSIONALISM COUNTS
Be sure to thank the persons for their consideration. Use the term, “please,” whenever you want something. You’ll find that 98 percent of all communications provide an opportunity for one or both courtesies.
USE COURTESY