Claims contractors suck

Today has been a day and a half i swear. 

I work at a call center and I only got long calls today. I'm talking 30 minute to hour long calls. Calls usually last between 5-10 minutes in my department. A long call doesn't mean I'm stupid or can't do it, it just means that the caller has a more complex issue than most people calling in, and it isn't a transfer call. That, or it's a translate call, which requires me to get a translator on the line. This is for any language that is not English or Spanish. Spanish calls I just transfer to a Spanish speaking CSR.

 But they were all long and complex. There have been issues with claims. I think something is wrong in out system. We had issues One of our claims contractors last year at about the same time, and we just started started having problems with them again. This year, they're denying things that shouldn't be denied again, but this time it's because "[Insurance] doesn't cover that"

But in the Database, I can clearly see that [insurance] DOES cover those services and [contractor] just doesn't want us paying. I don't know why. So, once I get to the point I can't answer their questions, I get to send them up to a Claims CSR and type out a tiny essay saying that Scripting clearly states that [insurance] covers this service, but [contractor] denied it saying we don't. 

Like, is there a way to flag the contactor so they can get there rumps back in gear? Do i tell the caller to have the provider resubmit the claim? Wouldn't it just be denied again? Do they file an appeal. The callers HATE filing appeals. It sucks and [contractor] is going to tell them the same thing, so they're going to have to be denied again to go to the second level of appeal. 

it's frustrating. 

and my site just got bought out. we get to keep out contract, but we will be with a different company. i hope that one is better than the current one. but do i have to sign ANOTHER nda? i don't know if it was with the company that just sold or with the insurance. 

this will be the third company that's run that site. i joined during [company 2]'s run, but i have no idea what to expect of [company 3]. they're a lot smaller than [company 2]. the name's a lot longer too.

when will [company2]'s name be scraped off the door? when will our system change over? will i be there for it or will it be over the weekend?

but, today is over. i was able to get a week's worth of training done today, so at least it doesn't all feel like a waste.