Malicious compliance, friends…
If you aren’t exactly sure what that phrase means, let me fill you in: it’s when a person knows something is wrong or foolish but they go along with what they’re told anyway in order to teach others an important lesson.
And the malicious compliance story you’re about to read turned out to be an EXPENSIVE one.
The person who wrote it said that they work as a bookkeeper, so you can assume that they know their stuff when it comes to finances.
I was taking too many liberties…
“I’m a bookkeeper working for a law firm, specializing in receivables and trust accounting (keeping track of what money in the trust account belongs to whom, and what we can do with it).
We also work for a lot of insurance companies on their specialty lines, for example, if a bank makes an insurance claim because it discovered one of its clients was running a Ponzi scheme through their accounts, but insurance refuses to pay out because bank employees were involved, which is excluded by the policy, and the bank sues over this, we would represent the insurance company.
Insurance companies have lots of rules for how you bill them, words you can and cannot use, activities you can and cannot bill, etc. and it’s part of my job to know these guidelines and make sure our bills are compliant with them.
A lot of insurance companies mess up.
Unfortunately, many of these insurance companies use a third party administrator (TPA) to review their bills, and adjust them if not in compliance with the guidelines, and they’re often wrong. This leads to appeals, which have their own requirements, that I also must know.
The result of all of this is that in order to get these bills done properly, and collect as much as possible on them, it takes a lot of communication with our vendors, and lawyers, and the claims counsel at the insurer.
They were only doing their due diligence.
For most of my time at this firm, I have simply reached out as needed to anyone I need to clear up billing issues, and keep the issues requiring a lawyer’s attention to a minimum.
Additionally, nearly all of the claims counsel have told me to reach out to them as needed for billing issues. The lawyers’ value is in providing advice to our clients, not in billing minutiae that I am perfectly capable of dealing with, and my job is to support them by dealing with the minutiae. Or so I thought…
Not everyone was happy with what they were doing.
It turns out a bunch of lawyers were unhappy with me reaching out to claims counsel whenever I needed to, and not making the request to the lawyer to reach out to claims counsel for whatever I needed. Okay, fine. It’s not like I don’t have other work to keep me busy for the rest of time, you want to deal with this stuff, you go ahead.
Needless to say, the lawyers were (still are) completely oblivious to the amount of work my job entails (I guess that’s my fault for doing a good job all these people years). So far we’ve missed several appeal deadlines, resulting in about $25,000 in foregone revenue.
There’s a method for most insurers for appeals after the fact, but it doesn’t really work for, “we didn’t email you before the deadline, would you please approve it now anyway?” The managing partner asked me if we could do an appeal after the fact, he’s spent a week working out how to say, “yeah, it’s our fault, but would you please still fix it for us?”
The money kept adding up.
There’s another $25k in appeals due on Monday which we need claims counsel to approve, so the TPAs will process the appeal, and the lawyer who has to get me the approval is away Thursday and Friday.
There’s another probably $50k in appeals on other files which are due by the end of the month.
I could fix everything with a couple phone calls, but I’m not allowed to make them.
And the clock continues to click down.
Ouch!
Claims counsel won’t reach out to me unless they need to (I dropped enough hints that they understand what is happening, and are supporting my malicious compliance), so we’re both watching the clock tick down…
I wish I had $125k to toss away because I didn’t want to let someone make a phone call.”
Check out how Reddit users reacted to this story.
One reader said they need to be documenting EVERYTHING.
This individual made an excellent/obvious point.
Another person apologized…check out what they had to say.
This Reddit user said they need to be sharing these figures.
And one individual thinks they know what’s going to happen…
A whole lot of money down the drain.
That’s not good, friends!