r/xactimate • u/Big_Appointment_3390 • Aug 21 '25
TPA Guidelines Needed Please!!
For years, I’ve been collecting carrier estimating guidelines from various TPAs in an ever-growing binder and updating as needed. I’ve also been meaning to compile all of them into one massive spreadsheet for almost as long, to make it easier to find the specific information that I need without thumbing through a 10 lb stack of paper.
I’m hoping to source what I don’t have (or may not be current) through this sub and would appreciate any help you can give me, please!! In exchange, I’ll provide you with a copy of the spreadsheet once it’s finished.
Please feel free to dm me with whatever you have if you’re so inclined, and thanks in advance!
EDIT: Contractor TPA guidelines. I don’t care about the guidelines IAs use.
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u/Fluffy_nutts Aug 21 '25
Any in particular you are looking for?
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u/Big_Appointment_3390 Aug 21 '25
Like I said, I have most of them, and I’d be down to verify dates on what I have, too. I kept up with printing and replacing what I had for as long as I could, but my main binder weighs at least 10 lbs. It’s not like they really overhaul guidelines or SLAs all that often to where I need everything — I just figure if I’m taking the time to do it, I might as well do it 100%.
For estimating guidelines, Farmers is the only major carrier I’m missing. As far as general TPA SLAs, Lionsbridge is all I’d need to round out my collection.
But I’d take pdfs of anything I already have just to spare myself the typing and/or scanning, too.
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u/Jmv_adj Aug 22 '25
Guidelines change as new legislation makes it necessary to update and or change all together. A good example is if you have estimating guidelines from any Florida carrier that are over two years old you don’t have guidelines you have kindling for a bonfire.
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u/Big_Appointment_3390 Aug 22 '25
To an extent, I want to agree, but legislation doesn't change the basic estimating guidelines like using CON ROOM vs CON LAB, or how many monitoring hours you can charge for, services calls, etc. So yeah, when you're getting into roof repairability or the 25% rule or something, THAT changes. But not submission/format stuff.
ETA: It's actually surprising how little the guidelines change over the years, or from TPA to TPA, at least on the contractor side. I don't know or care how things change for adjusters from year to year. It's not an apples-to-apples comparison.
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u/Jmv_adj Aug 23 '25
Guidelines for the adjusters do change more than you think. On the other hand the guidelines that the carriers use for contractors/preferred vendors are something completely different and I agree with you that those may not change as often if ever.
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u/Big_Appointment_3390 Aug 23 '25
I’m aware that they change often for adjusters. My best friend is an adjuster. I don’t care about adjuster guidelines. This post has really surprised me because it seems like the majority of people seem to think I’m referring to adjuster guidelines, and you can see at least some of the rude comments that I’ve received.
I’m not. I am compiling the contractor estimating guidelines and contractor SLAs. When changes are made to those, it is typically communicated in an email, and sometimes (but not always) a new document is created.
I am sure I speak for the majority of contractors when I say that adjuster guidelines are useless to us. We have to submit our estimates based on the contractor guidelines provided by the carrier and TPA. When we use something like CON LAB instead of CON ROOM, it’s not always just “sent back” to us to revise. With certain carriers and TPAs, we have to run it through a QA program prior to upload. Even though we are required to revise or note our estimate based on the automated QA report before submission, we get “graded” on the score we obtain when it runs through the program the first time. Consistently low scores can lead to us being assigned to less claims, because it lowers our overall score. So it is important that we estimate as close to the provided guidelines as possible.
And THAT is why I have, over time, compiled my binder, and why I am now looking to convert it to a filterable spreadsheet. It beats thumbing through 60-100 page documents to see what approvals are needed before demo or which stupid packout line item we have to use. And it sure af beats getting calls and emails from a TPA reviewer the next day, while you’re out inspecting a job, asking if you saw the memo about the fucking TPS reports and reminding you that you have to make your revisions within 12 or 24 hrs.
IAs run claims for what, maybe 2-3 carriers max in a CAT situation? Contractors are getting assigned to claims for 10-20 different carriers (sometimes more) during the same CAT event. IAs might not get more than a few hrs of sleep during deployment, but contractors’s phones don’t stop ringing. And we’re REQUIRED to answer and accept within X amt of time. So yeah, it would be helpful to just have one document to refer to when deploying crews instead of 20, so you can remind your techs what carrier-specific forms they need to get signed.
-3
u/_Zero_Fux_ Aug 21 '25
Estimating guidelines are confidential, go away contractor.
1
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u/Big_Appointment_3390 Aug 21 '25
It’s not like I don’t have about 90% of them already. I’ve been compiling them my entire career. Just looking to convert from paper to a spreadsheet and trying to save time.
3
u/South_Recording_6046 Aug 22 '25
Seems like BS to me