Overview

This document provides a structured approach to billing trade approvals and supplements separately for certain clients. It explains the process, key definitions, and best practices to ensure clear and accurate billing when handling trade and partial approvals. By following these guidelines, we can improve transparency, minimize confusion, and maintain consistency in client communication.

Definitions

A Trade Approval or Partial Approval occurs when only a specific trade (e.g., roofing, siding) or a portion of it is approved by insurance. In these cases, the client is billed separately for the approved trade items. However, this applies only to the primary trade item itself (e.g., shingles, siding) and does not extend to related components such as vents, flashing, or underlayment. Any remaining items under review continue to be classified as part of the supplemental billing process. This distinction ensures that billing reflects what has been fully approved while keeping supplemental negotiations separate.

Which Clients Follow This Billing Model?

• Not all clients follow this structure. Some are charged at full rates, while others receive partial approval billing adjustments.

• Each account manager should track which clients are eligible for this model.

• A clear list should be maintained and updated as needed.

Billing Process:

To ensure clear and consistent billing, follow these steps:

1. Determine the Total Increase:

• Identify the original claim amount and the final approved amount.

• Example: If the claim started at $1,000 and ended at $20,000, the total increase is $19,000.

2. Separate Trade and Supplement Approvals:

• Identify how much was approved under trade items versus how much was secured through supplemental negotiation.

3. Communicate Clearly with Clients:

• Present the total increase.

• Break down how much of the increase falls under trade approvals versus supplements.

• Provide clear documentation showing the exact line items included in trade approvals.

4. Confirm with the Client Before Billing:

• Send an email summarizing the approval breakdown.

• Follow up with a call to answer any questions.

5. Standard Billing Communication Template:

This claim was supplemented and includes a Trade Approval.

Total Increase:

RCV (1) = Original RCV

RCV (2) = Final RCV (i.e., approved RCV)

___________________________

Increase = Amount and %

Separation of roof/siding approval from supplements for invoicing:

Roof/Siding RCV (1) = Original Roof/Siding RCV (specific line item)

Roof/Siding RCV (2) = Final Roof/Siding RCV (specific line item)

___________________________

Roof/Siding approval increase = Amount

Separate Supplemental Increase:

Total Increase = $

Roof/Siding Increase = $

___________________________

Supplemental Increase = Amount

[Can give brief description here about specific items warranted or not warranted by insurance]

[Sign your name/ #]

      6. Task Vlad to bill the client: After you have aligned with your RF and they are ready to close the claim, please create a task for Vlad to bill and move the stage to Bill the client. Add an end date in the AM input sheet to get your billing date. 

In your Billing Task to Vlad, please write that it was a trade approval -- e.g., "Please bill the client -- Trade approval."

Best Practices & Common Challenges

• Defining Partial Approvals Clearly:

• Only the directly approved trade item should be considered under partial approval billing.

• Example: If only one side of siding is approved, the approval applies to that specific siding, not associated items like house wrap or vents.

• Avoiding Confusion in Calculations:

• Ensure the trade approval and supplement figures add up to the total increase.

• Use itemized breakdowns to explain the calculations clearly.

• Providing Transparency:

• Always explain the breakdown to the client, either via email or a direct call.

• If needed, walk them through the exact claim line items contributing to the increase.