Imagine if you knew that $2 million of your company’s money was scattered across the streets outside your office. It’s a windy day, your staff is tied up at a training session, and you’re meeting with clients all afternoon. Would you let it blow away?
The truth is, health insurers all over the country are throwing away millions of dollars each year, either by not performing or underperforming critical cost containment measures, such as subrogation and coordination of benefits. See how one community health plan boosted its savings by millions in a matter of months.
A western region Blues health plan wanted to modernize its subrogation operation and empower the in-house team to work more efficiently and deliver better results.
As part of this effort, the health plan wanted to move from paper storage to state-of-the-art integrated case management, and from manual reporting to user friendly, on-demand analytics. It also wanted to support and enhance existing prepayment processes in addition to creating a stronger recovery-based model. Very importantly, the health plan wanted to maintain control over the recovery process by relying on its in-house team.
To download and read how this health plan modernized its subrogation process, just complete the quick form below:
Discovery Health PartnersCase study: Western region Blues health plan modernizes its subrogation operations
A prominent regional Southwestern health plan wanted to reduce erroneous claims payments and maximize its healthcare cost containment program. Working with Discovery Health Partners, the plan now uses automated case management, data mining, and reporting tools for processes such as subrogation, coordination of benefits (COB), and overpayment. This case study highlights how the health plan achieved:
Increasing its volume of recoveries
Recovered Medicare Advantage premiums faster
More flexible reporting
Better response and attention from its vendor
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Discovery Health PartnersSettlements approach $3.5 million from cloud-based cost containment solution
A 25-year-old community health plan from the Northeast wanted to simplify its subrogation and COB processes and improve overall savings. The organization had been managing these functions on its own using internal staff to manually track savings and paper files, but wanted enhanced data mining to help them discover more cases they weren’t already processing. The team also needed more insight into the inventory of cases in process so it could forecast expected recoveries.
Complete the quick form below to download and find out how this health plan increased its savings by more than $2 million in less than one year with Discovery Health Partners.
Discovery Health PartnersCommunity health plan boosts subrogation and COB savings by more than $2 million in seven months
Whether they realize it or not, most healthcare payers are losing millions of dollars each year across cost containment activities such as COB, subrogation, eligibility, MSP validation, and more.
Fortunately, a new generation of “intelligent” cost containment solutions helps cut the losses and achieve significantly better results. Modern cloud and analytic technologies and streamlined processes lead to improved recoveries, cost avoidance, and increased revenue – all of which support health reform priorities such as medical loss ratio and waste and abuse efforts.
In this white paper, you’ll learn:
Real-world examples of “intelligent” cost containment success
How technologies such as cloud computing and analytics are transforming cost containment and delivering measurable business value
Best practices for getting started on an “intelligent” cost containment path
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Discovery Health PartnersWhite Paper: Innovations for Cost Containment for Healthcare Payers
A sea of change is happening in healthcare cost management. Recovery specialists say many issues are hampering their programs—legacy systems based on antiquated technology, lack of integration among information sources, inflexible reporting, partially automated claims recovery processes, passive case management, lack of visibility.
At the forefront of new technologies rapidly changing healthcare recovery is Software-as-a-service (SaaS). On-demand software for subrogation and overpayment is delivered instantly and less expensively to desktops via the internet “cloud” instead of running on internal systems. These SaaS solutions, available from Discovery Health Partners as an alternative to its Full Service Subrogation and COB, combine leading-edge technology advancements, modernized workflow, and powerful information analytics.
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Discovery Health PartnersBusiness Case: the SaaS [r]evolution in healthcare recovery
There’s a strong business case for periodic verification of eligible dependents — perhaps even more so in the wake of healthcare reform. Our perspective paper, “Dependent Eligibility Verification: 8 Reasons Why It Makes More Sense Than Ever,” documents the many reasons why a dependent eligibility audit is a best practice and will deliver a return immediately and over the long term in terms of reduced claim costs.
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Discovery Health PartnersWhitepaper: dependent eligibility verification