Unauthorized Work

Unauthorized Work

Per the terms of the service agreement, all repairs must be initiated and approved by Cinch in advance.  
If a customer calls to open a service request after they have already completed the work, it is considered Unauthorized Work. 
Some states have specific unauthorized work procedures. 

Info included below: 
  1. California and Iowa Unauthorized Work Procedures
  2. Unauthorized Work Procedure – All other States
  3. Oklahoma, Iowa, and Utah Emergency Claim Review Process
Warning
The customer must be informed of the unauthorized terms as stated in their service agreement and advised of the correct service request procedure for future service requests.  

Unauthorized Work Script

“<Customer Name>, your agreement covers the <Item> due to normal wear and tear when we are notified before the repairs are performed.  
However, any service performed without prior notification and Cinch approval is not eligible for reimbursement. 
As a reminder, our Customer Service Department is available 24 hours a day, and you may request service through our customer online portal MyAccount.” 

If the customer persists and disputes the denial: 
“<Customer Name>, I can appreciate your questions. If you would like, I can refer you to the section in the contract that explains this important condition.”
  1. Refer to the section of the contract that addresses “authorized contractor” or “unauthorized repairs”.
  2. If the customer states they never received a contract, offer to send them one and contact Membership Services to process the request. 

California and Iowa Unauthorized Work Procedure

When a customer calls to request reimbursement for unauthorized work in California or Iowa, per state regulations, we must verbally explain the unauthorized work terms, and a denial letter must be mailed to the customer. 
  1. Use the Unauthorized Work Soft No Script to educate the customer on the unauthorized work terms and future service request process. 
  2. Submit the Mail Correspondence Request Form for a Denial Letter to be mailed. 
  3. Enter a comment in the SB CEC Notes outlining your interaction, including: 
    1. California or Iowa Unauthorized Work discussed
    2. Customer advised of Unauthorized Work Terms 
    3. MC Request form submitted for denial letter 
  4. If the customer escalates:
    1. Instruct the customer to send in their paid invoice and any supporting documentation to SupportServices@cinchhs.com for review.
    2. Documentation must be on company letterhead and include:
      1. Service company name (logo), mailing address, phone number, and email address.
      2. A photo of the manufacturer’s data plate showing the model and serial number of the existing unit.
      3. Location of the unit.
      4. Diagnosis from your Service Professional detailing the parts that failed and the cause of failure.
      5. Itemized list of parts, including part numbers and pricing for each.
      6. Itemized labor, including number of hours and cost per hour.
      7. Detailed breakdown of costs for modification, upgrades, disposal, and permit fees. 
  5.  Enter a comment in the Service Bench CEC Note Pad outlining the interaction, customer was advised of unauthorized work terms which they did not accept, and customer was advised to send in documentation for review.  

Unauthorized Work Procedures - All Other States

When a customer calls to request reimbursement for unauthorized service, use the Unauthorized Soft No Script to advise the customer of the reason their Service Request is unauthorized. 
  1. If the customer accepts the unauthorized work soft no explanation, enter a comment in the SB CEC notepad outlining the interaction stating the customer was advised of Unauthorized Terms.  
  2. If unable to resolve or if the customer escalates:
    1. Instruct the customer to send in their paid invoice and any supporting documentation to SupportServices@cinchhs.com for review.  
    2. Documentation must be on company letterhead and include:
      1. Service company name (logo), mailing address, phone number, and email address. 
      2. A photo of the manufacturer’s data plate showing the model and serial number of the existing unit.  
      3. Location of the unit.  
      4. Diagnosis from your Service Professional detailing the parts that failed and the cause of failure.  
      5. Itemized list of parts, including part numbers and pricing for each.  
      6. Itemized labor, including number of hours and cost per hour.  
      7. Detailed breakdown of costs for modification, upgrades, disposal, and permit fees.  
  3. Enter a comment in the SB CEC notepad outlining the interaction, customer was advised of unauthorized work terms which they did not accept, and customer was advised to send in documentation for review.  

Oklahoma, Iowa, and Utah Emergency Claim Review for Reimbursement

Cinch has a legal requirement in OK, IA, and UT to review a customer’s unauthorized work invoice if the claim involved loss of: 
  1. Air conditioning in summer
  2. Heating in winter
  3. Water or Electricity to the entire dwelling 
Follow this process and advise the customer of the reimbursement review instructions: 
  1. Confirm the customer resides in Oklahoma, Iowa, or Utah.
  2. Use the Emergency Unauthorized Script to educate the customer of the Unauthorized Work Terms and future service request process.
  3. Instruct the customer to send in their paid invoice and any supporting documentation to SupportServices@cinchhs.com
     for consideration of possible reimbursement. Documentation must be on company letterhead and include:
    1. Service company name (logo), mailing address, phone number, and email address.
    2. A photo of the manufacturer’s data plate showing the model and serial number of the existing unit.
    3. Location of the unit.
    4. Diagnosis from your Service Professional detailing the parts that failed and the cause of failure.
    5. Itemized list of parts, including part numbers and pricing for each.
    6. Itemized labor, including number of hours and cost per hour.
  4. If the customer is sending in a copy of their paid invoice, enter a comment in the Service Bench CEC Notepad. Make sure to outline the interaction including the state of residence, unauthorized work terms advised and instructions to send in documents for review. If the customer refuses to send in documents for review notate the SB CEC accordingly.

Emergency Unauthorized Script - Oklahoma, Iowa, Utah

"<Customer Name>, your agreement covers the <Item> due to normal wear and tear when we are notified before the repairs are performed. As per the agreement terms and conditions, any service performed without prior notification and Cinch approval is not eligible for reimbursement. We will be more than happy to review the paid invoice/work order for possible reimbursement based on our service cost minus your deductible and any non-covered charges. Would you like our contact information to send in your documents for review?”
If YES, advise the customer of the below information:
  1. Email: supportservices@cinchhs.com OR Fax: 954-845-2280 (send Attention: Unauthorized Work Review) OR
     Address: Cinch Home Services Attention: Unauthorized Work Review PO Box 810275 Boca Raton, FL 33481-0275
“As a reminder, our Customer Service Department is available 24 hours a day, 365 days a year to provide assistance for any of the covered items listed in the terms and conditions of your agreement.” 

Support Services Process

  1. Correspondence Request for CA/IA received: 
    1. Enter a note on the CEC Note Pad /Customer Notes using the Unauthorized Work note template.
    2. Add the job information to the CA/IA Denials to be added to the Batch spreadsheet in the Team’s folder to have it added to the master list of denied jobs for CA/IA management review. 
    3. Note the CEC Note Pad/Customer Notes. 
      CORRESPONDENCE REQUEST: CID #. Request for CA/IA denial. Added to the batch to have the denial letter mailed. 
  2. When an invoice is received and there is no job created prior to the date of service on the invoice or the customer qualifies for the OK, IA, UT, Emergency Claim Review process: 
    1. Create an APO job with the deductible as SP will collect.
    2. Attach the documents removing any credit card or bank information.
    3. Open a SS-Unauthorized Claim Review exception in open status. 
    4. Respond to the customer with UNAUTHORIZED OUTGOING RESPONSE.
    5. Note the job using Supporting Doc Review template.
  3. When an invoice is received and the job is assigned to an in-network provider, AND the customer does not qualify for the OK, IA, UT Emergency Claim Review process:
    1. Attach the documents to the in-network provider job removing any credit card or bank information.
    2. Note the job using Unauthorized Work template. 
    3. Respond with the template, Unauthorized Work Response. 

 Reviews job to determine if the work is considered unauthorized.  

  1. If Unauthorized Work is upheld: 
    1. Update the sub-status to Job Not Covered.
    2. Document account using APO Review template. 
    3. Submit to Denial Tracker for final determination by the Decision Desk following the APO Review process. 
    4. If the customer qualifies based on the OK, IA, UT Emergency Claim Review or the work is deemed to be pre-authorized, review for reimbursement based on coverage following the APO Review process.   

Revised 2/25/25

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