1 / 22

Insurance Claims Resolution and Self-Pay Recovery

Insurance Claims Resolution and Self-Pay Recovery. Spend more time with patients, and less time worrying about receivables. Transworld & the Healthcare Industry:. Professionals Working with Professionals.

keiki
Download Presentation

Insurance Claims Resolution and Self-Pay Recovery

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Insurance Claims Resolutionand Self-Pay Recovery Spend more time with patients,and less time worrying about receivables.

  2. Transworld & the Healthcare Industry: Professionals Working with Professionals • Transworld has been a professional partner to the medical practice industry for more than 38 years. • We are a member of ACMPE. • We are the ONLY Collection Company that is an Adminiserve Partner of the MGMA ($230M Recovered, 53% Recovery Rate, 2.5% Cost as of May’07) • We are the only agency that is Peer Reviewed by the HFMA • We currently work with over 20,000 healthcare facilities nationwide You can be confident we know your business. * HFMA staff and volunteers determined that this product has met specific criteria developed under the HFMA Peer Review Process. HFMA does not endorse or guaranty the use of this product

  3. Transworld Systems Inc. We’re in the business of profit recovery. We lead the industry in providing medical practices with better tools for recovering slow paying patient accounts and expediting reimbursement from insurance companies. • In the past 5 years, we have recovered $2.4 billion for our clients • Over 30 years of experience recovering slow-paying and delinquent accounts. • More than 120 offices across the United States. • “ Transworld gets credit for the highest recovery rate in the industry.” - Barron’s

  4. GreenFlag: Cost Efficient • Reduce in-house costs dramatically, by having the insurance company contact you directly. • A low fixed rate that equals pennies on the dollar collected. • Low, fixed cost allows our service to be utilized on claimsas early as 30-45 days past due. • Carriers pay you directly – no waiting 30-60 days to have access to your capital. • The program works as an extension of your billing office

  5. GreenFlag: Easy to Use • GreenFlag standardizes the accounts receivable procedure: • We work the claims you choose, making A/R more predictable and cash flow steadier • We contact the insurance companies on your behalf regarding unpaid claims. Since we are regarded as a third party, the insurance company must respond to you regarding the resolve of unpaid claims or their bond rating will be adversely affected. • Insurance carriers will then contact your staff to provide you with the resolve on claims we submitted on your behalf. • Claims can be easily submitted/uploaded and managed 24/7 on the internet via our ONYX Customer Portal (OCP)

  6. Hidden Cost of On-Hold Time If your insurance billing clerk is on hold for just 3 calls per day at 20 minutes per call to follow up on just 3 claims, and if they work 50 weeks per year, you are paying . . . . Assumption: Hourly Wage = $15.00 (including overhead) # of insurance follow up personnel Amount paid per year for employee’s to sit on hold $7,500 2

  7. Third Party Impact Differentiates your Claim

  8. Why GreenFlag Profit Recovery? • Insurance carrier by-laws and internal policies typically require immediate response to our licensed third party contacts. • Our third party demand moves the responsibility for the claim from a clerk to a supervisor, who settles the claim more quickly. • Our average fixed fee of less than $10.00 per claim allows you to utilize this unique service on claims as early as 30-45 days past-due.

  9. Insurance resolution Month 1

  10. Insurance resolution Month 2

  11. Insurance resolution Month 3

  12. Insurance Resolution Results:

  13. How do you benefit? • Using GreenFlag Profit Recovery at 30-45 days allows your staff to focus their attention and efforts on claims in the 0-30 day window. This reduces the number of claims reaching 60 days. • Quicker resolution of claims means patients get billed faster for their share of the balance, reducing the number of outstanding self-pay issues.

  14. Self-Pay Recovery Spend more time with patients,and less time worrying about receivables.

  15. The Power of Fixed Fees How does the power of GreenFlag’s Fixed Fees work? • You pay only a fixed fee for each account • Fixed fees average $10* per account • No percentages are taken with GreenFlag services • *Company average

  16. Listen to the Experts “In addition to the superior collection rate and speed of recovery, Transworld’s low fee provides the client with a 30%-70% savings.” • — FORBES Magazine

  17. The Power of Written Demands Why do GreenFlag written demands work so well? • Return address is from one of the 130 offices nationwide • You choose the tone of the demand: diplomatic and more intense • You have messaging options • We’ll send Thank You notices upon request to help you retain valued customers

  18. The Power of Control Why is it important to be in control of submitting & withdrawing accounts? • You need to be in charge because this is your business. • You decide which accounts should get attention and how aggressive to be • You decide when to add, delete or put accounts on hold – and we charge no penalties • You check your “real time” reports 24/7 so you can make the best choices for your accounts

  19. 24/7 “Real Time” Reporting • Client controls all starts and stops • Ability to access, update, and manage accounts online • Real-time, web-based account reporting • 24/7 access to account information

  20. GreenFlag Advantages • PAY LESS • GreenFlag flat fees average less than $10 per account. • NET MORE MONEY • No percentages taken; all recovered money sent to you • RAPID RESULTS • Early action by an outside party motivates payments • RETAIN CONTROL • 24/7 web access to manage accounts in “real time”

  21. Results of aggregate Chiropractic clients Cost Per Account : $13.25 AvgBalance: $696.55 Avg Age of Accts (Months):    12.2 Recovery Rate Net Dollars Assigned:   $131,111.50   % Recovery Rate on Net Dollars Assigned:39.0% % Recovery Rate on Total Dollars Assigned:37.5% Return on Investment Collection Cost as a % =  Cost of Accounts Submitted /   Total Performance  5.5% R.O.I: (based on accounts submitted to date)1806.6% For every dollar invested, Transworld Systems returned:$18.07 For every account assigned, Transworld Systems returned:$235.62

More Related