Over the last month, ProviderLAW has researched several different PC software products that enable health care providers to record telephone conversations with insurance payers. The purpose of this Advisory is two-fold – (a) to review the main rationales for acquiring telephone recording capability, and (b) to summarize the features of four different software products. For your convenience, a product comparison chart (with list prices) is included at the end of this Advisory.

Many states have laws that protect you in cases where a carrier tells you there is coverage (and there isn't), or where a carrier tells you that you're "in-network" (and you aren't), or where a carrier fails to tell you about a material limitation in coverage, or where an adjuster tells you they will pay you directly (and then doesn't), etc., etc., etc. The list of situations where a carrier tells you one thing, and then does another, goes on and on. Getting paid in such cases is partly a matter of knowing the general law on point, partly a matter of knowing which state law applies [Endnote 1], partly a matter of having quick access to that state law, and partly a matter of having access to various tools (such as demand letters and other follow-up devices) for convincing the carrier to pay you.[Endnote 2] Getting paid in such cases, however, is also partly a matter of proof, i.e., having the ability to quickly demonstrate to the carrier or adjuster what was actually said at the time of verification. Case in point – over the last month, we have been contacted by two ProviderLAW subscribers who – after citing the relevant state law and providing evidence of the conversation – were successful in getting the carrier to pay them after the carrier had misstated the benefits and then had refused to pay. In one of those cases, the carrier had failed to mention a $500 cap on care. Upon receiving a demand letter and evidence of the conversation from the provider, the carrier agreed to pay the provider in-full, thereby saving the provider / patient over a thousand dollars. These and other cases illustrate the potential for getting paid when the carrier tells you one thing, and then does another.

The answer to this question is simple. When it comes to (a) ensuring that most or all insurance conversations get recorded, (b) simplifying the process of archiving, retrieving, reviewing, copying, and transferring recordings, and (c) preserving the evidentiary integrity of the recordings (i.e., being able to admit them into a court of law if necessary), there simply is no alternative to recording conversations through digital means such as software. Software creates the potential for recording all conversations automatically, which eliminates the possibility that an insurance call will go unrecorded. Software makes it possible not only to easily save and find recordings, but also to copy and to transfer recordings to an attorney or adjuster. Software creates a potential for "tamper-proofing" the recording so as to enhance your ability to later admit it into a court of law, or, more importantly, convincing a carrier or adjuster that you will be able to admit it into a court of law. When one considers the potential power of recording conversations with insurance companies, the affordability of the software, and the time and money that can be saved by "doing it right," there is little doubt that software represents a far more powerful and cost-effective solution than tape recording.

It should be noted that when it comes to digital means for recording conversations, PC software isn't the only solution. Separate, stand-alone digital recording devices have existed on the market for quite some time. Very good stand-alone systems are generally available at $850 and up (single-line systems) and $2000 an up (multi-line systems). If these prices are not out of your price range, we encourage you to speak with a manufacturer regarding such solutions.

The purpose of this section is to save you time, money, and confusion when it comes to purchasing telephone recording software. For the purposes of this Advisory, we're assuming that your practice is using a multi-line, digital phone system, and not an analog phone. We're also assuming that your practice has one or more desktop PCs in the office which may or may not be networked.

With respect to computer input, there are basically three types of software for recording telephone conversations: (a) software designed to utilize a voice modem, (b) software designed to utilize a sound card, and (c) software designed to utilize a USB port. Some software programs can be configured to work with any one of these three. The main problem with the voice modem approach is that voice modems generally produce a very low quality recording. Sound card and USB connections, on the other hand, produce a much higher quality recording. For this reason, we will focus primarily on the sound card and USB approaches in this Advisory.

For all practical purposes, sound cards give you the ability to connect a single phone station or extension to a single PC and to record all conversations on that particular extension either on-demand or automatically as determined by the user. With the sound card approach, if you want to record conversations on an additional phone extension, you can do so, but only if you have another PC in the office. [Endnote 3]

In light of the foregoing, there are two potential "downsides" to the sound card approach in the health care setting. If either or both of these disadvantages apply to you, you may wish to take a USB approach instead.

The first potential downside associated with the sound card approach is that you may already be using the sound card on your computer [Endnote 4] for some other recording purpose. It is generally understood that a desktop PC can only accommodate one sound card. If you have already reserved the sound card for another recording purpose, the USB approach may be the way to go.

The second potential downside associated with sound cards has already been stated but merits further explanation. The sound card approach won't allow you to record multiple conversations simultaneously through the same PC. In other words, if you have two phone stations or extensions next to one desktop computer, for all practical purposes you'll have to choose which extension gets the recording capability. Since PCs can have multiple USB ports, the same limitation does not apply to USB-based solutions. It should be noted, however, that the USB approach not only creates the potential for recording multiple phone calls simultaneously through the same PC, it also creates the potential for recording phone calls automatically as determined by the proprietor of the practice or system administrator. [Endnote 5]

The specific advantages of the USB approach have already been discussed in the previous sections, and therefore won't be repeated here. The point is that when it comes to hardware, there should be little doubt that the USB approach provides more flexibility than the modem and sound card approaches.

In determining the best software solution for your practice, we recommend that you take a three-step approach. The first step is to review the chart of products outlined in the next section and to become familiar with the features of such software. The next step is to consider searching the Internet for any other products that may exist. The third step is to shop the Internet for the right price. Bear in mind that a developer's web site may only include the list price. One product which we reviewed (see below) was able to be purchased through hellodirect.com (a retailer) at 70% off the developer's list price. To search the Internet for the best price, simply enter the product name as the keyword search string in the search engine of your choice (e.g., www.google.com), and see which retailers are offering the product at what price.

The following systems were researched on www.google.com and represent the result of a series of searches performed on and before the date of this Advisory. Stand-alone recording devices and modem-only software solutions have been omitted. Except where otherwise stated, all of the systems below are able to utilize, or require use of, a sound card. All information appears as advertised or represented by the developer. Each product may contain additional features. For more information regarding a particular product (e.g., additional features, limitations, system requirements), we recommend that you visit the developer's web site.

As stated at the beginning of this Advisory, getting paid in cases where an insurance company tells you one thing and then does another is partly a matter of proof, i.e., having the ability to quickly demonstrate to the carrier or adjuster what was actually said at the time of verification. However, getting paid in such cases is also partly a matter of knowing the general law on point, partly a matter of knowing which state law applies [Endnote 1], partly a matter of having quick access to that state law, and partly a matter of having access to various tools (such as demand letters and other follow-up devices) for convincing the carrier to pay you.

As part of your subscription, you have access to all of these resources in the "subscribers only" section of our web site. If you have any questions, please do not hesitate to call.