(602) 626-3008
Home » FAQ
a

Frequently Asked Questions

Table of Contents

What OCS does / doesn’t do.

No. We don’t work on old, past-due receivables. However, we’ll process any invoices that haven’t already been sent to the carrier, even if the job occurred prior to signing up with us.

No. We don’t prepare invoices for you, but we can refer you to a well-qualified estimator if you need help writing invoices. As a part of our service, our attorneys will review your current invoicing practices and make recommendations that you (or an estimator) can implement to improve your billing prior to getting started with us.

Currently, we only focus on insurance invoices for emergency services such as water mitigation, asbestos abatement, pack outs, mold remediation and fire demo and cleaning. That being said, we may add reconstruction billing to our service offering in the future – be on the lookout!

It depends. If your franchisor restricts your business with regards to pricing, scope or negotiating with insurance carriers, then we probably can’t help. But, if you have more autonomy, we can explore our options of working together.

Yes, we can. That said, a lot of commercial jobs come through TPAs or important carrier relationships, so it may depend on how you get those leads.

No. TPAs, and the contracts they sign with carriers heavily constrict your ability – and ours – to get you paid faster and increase collections.

What’s your experience doing this?

Since starting in 2016, we’ve processed ~40,000 invoices with $200+ million in claim value collecting more than $170m on behalf of our clients.

We work with all insurance agencies and have close ties with many of them. We won’t turn away your invoices because of the carrier, even if they’re notoriously tricky to work with.

If the state(s) you operate in allows an insured to sign an assignment of benefits (AOB), then One Claim can work for you. Most states support AOBs, but reach out to see if you’re unsure.

We have a lot of happy clients. Check out our testimonials to get a feel for what restorers think about our services and what it’s like working with us.

What are the benefits?

Almost always.

We get our clients paid in 32 days on average – though some get paid quicker. According to C&R, most (~80%) contractors wait 30+ days to get paid while almost 60% have receivables outstanding for more than 45 days! If you’re like most contractors, we’ll get you paid faster than the industry average.

Yes – for the most part.

You’ll still need someone to create the invoice, compile the claim documents and submit them to our Contractor Portal. You’ll also need someone to cash the checks we send to you and record them in your book of record (e.g., Quickbooks).

Most likely.

We’ll look at a few recent insurance invoices to see if there’s an opportunity for us to add value to them. For most of our clients, we’re able to increase collections more than enough to offset our fee – it’s pretty awesome!

We have a lot of happy clients. Check out our testimonials to get a feel for what restorers think about our services and what it’s like working with us.

How to get started?

It’s easy and there are no upfront costs or major implementations.

  • Schedule an introductory call – we’ll want to hear more about your business and ask a few questions.
  • Our attorneys will review your contract/work authorization and some basic invoice data (e.g., a few recent insurance invoices) so we can figure out how we can add value for you.
  • We’ll put an offer together. If you agree to it, we’ll have you sign a billing agreement and we’ll begin the onboarding process.

It helps us figure out how we can get you paid faster and increase your collections. It also allows us to understand your business better. Without a review of this information, it can be difficult for us to come up with an offer that we’re certain will work. This process also helps our contractors have a better understanding of their starting ground with OCS and helps set some expectations.

We have attorneys that are experienced in restoration contract law. They’ll read through your documents and suggest ways to make them stronger. In most cases, we recommend you adopt a work authorization that our attorneys developed to be more enforceable in discussions with carriers.

For the most part, yes – it makes the billing process much easier for everyone involved. Call us to talk through alternatives as we’re also experienced with Direction to Pay agreements.

It’s pretty simple – just two steps:

  1. Sign a billing agreement and share your customer service and billing preferences with us so we can get you into our systems.
  2. Make the modifications to your work authorization and invoicing processes if you so choose.

Finally, you’ll start submitting your invoices and claim documents through our Contractor Portal, including ‘backlogged’ invoices from old jobs that haven’t been submitted to the carrier yet  – we’ll take it from there.

We don’t get paid until you do – OCS’s fee is a percentage of what we collect for you. Our fee varies depending on a few things, but in most cases, we can increase your collections to more than offset our fee. Please contact us to schedule a no-obligation consultation if you’re interested.

How does invoice submission work?

During onboarding, you’ll create a login to our Contractor Portal. There you will upload your invoice, documentation, and some basic information about the claim for each job. You can also email us, but know that it may slow down our internal processes. 

Three major steps:

First, we create and submit a claim packet to the carrier. The packet includes a cover letter from One Claim describing our justifications for the invoice and documentation.

Second, a claim advocate will proactively reach out to the adjuster on a regular basis to justify your invoice and ultimately accelerate it through the carrier’s billing process.

Lastly, we direct the carrier to cut a check and will stay on top of that payment until it gets to you.

Yes. Upon retrieval, we’ll let you know if something is missing or can be improved before submitting to the carrier. It will still be important for you to maintain a degree of quality control on your invoicing process.

How does justification work?

Our claim advocates have varying backgrounds, but most have been trained and are experienced in the justification process for insurance claims and/or working in a home services field. That said, these backgrounds aren’t a prerequisite and when a claim advocate lacks relevant experience, we make sure they learn what is needed to succeed in the role.

We have an extensive training program that an advocate must complete before they can assist in the claims process. This training covers many topics that cover laws surrounding work authorizations, assignments of benefits, variations in disaster mitigation practices, and how to communicate with different types of adjusters. It’s a thorough, time-tested, and proven training program.

This varies widely depending on several things – the carrier, type of job, size of claim, who is assigned to adjust the claim, etc. You should expect that your invoice is touched by a claim advocate every three days, at least. This cadence allows for constant communication between the adjuster and claim advocate. Especially when you take into consideration the research required on both sides to justify specific parts of an invoice.

It depends on the size of the contractor or complexity of their work. As a rule, the majority of your invoices will be handled by a small team of advocates. In some cases, we may flow invoices to a certain carrier through an advocate who has a deep relationship with the adjuster on the other side.

It depends on the size of the contractor or complexity of their work. As a rule, the majority of your invoices will be handled by a small team of advocates. In some cases, we may flow invoices to a certain carrier through an advocate who has a deep relationship with the adjuster on the other side.

No. Each invoice is only ever assigned to one claim advocate and that advocate will see it through the carrier’s entire billing process. As a rule, we will assign the majority of your invoices to a small team of advocates.

This will be contractor specific as there are many paths to take when a claim is denied. During our onboarding process, you’ll have the chance to hear a few options and define a path you’d like to take. In any case, denied claims seem to be rare as we’ve tried to build relationships with major carriers to help avoid that outcome.

We’ve developed procedures to avoid arbitration or litigation. However, sometimes it’s still necessary. We don’t initiate arbitration or litigation on our own, but we’ll support you if that’s a path you’d like to take.

This is somewhat rare given our focus on mitigation work – less than 10% of carrier checks we’ve seen include the mortgage company. That said, we have a team designated just for this. We work hand-in-hand with the homeowner through the mortgage endorsement process or obtain permission to process the endorsement through their mortgage company on their behalf.

Though rare, there’ll be times when we may need to communicate with the homeowner. When we do, we maintain the highest level of orientation to customer service.

No. We’ll deal with adjusters and carriers on your behalf. Leave that to us – after all, that’s one of the reasons you would consider working with us in the first place! However, there may be times when it’s beneficial for you to meet with the adjuster at the job location if requested.

We send a claims report to each of our clients on a weekly basis or as requested. These reports allow you to see where each claim is in the carrier’s claims process. Coming soon is a portal and integration that will provide you with live updates and visibility.

How does it work (payment)?

Oftentimes the carrier will make more than one payment. Typically, the first is for an undisputed amount and the remaining payments are for disputed amounts that we’re able to justify on your behalf. In all cases, we will track each payment until it gets to your mailbox.

We direct the carrier to send the checks to our office. Sometimes they may send them to you, and rarely will they mistakenly send them to the homeowner. In those cases, we’ll reach out to the homeowner and have them direct those checks to us. We’ll also work with the carrier to resolve the mistake.

We prefer the carrier sends us the checks so we can take out the fee and issue you a new check for the net amount. This transparency eliminates any additional billing to our clients and streamlines the process. That said, we can also direct the carrier’s check to you and then send a monthly invoice for our fee – it’s up to you.