National Other Party Liability Group (NOPLG) 2012

May 1- May 4, 2012, San Antonio, Texas

Presentation: Exploring the Business Case for Health Plan-directed Dependent Eligibility Audits

Speaker: Paul Vosters, President & COO, Discovery Health Partners

Thursday, May 3, 1:15-2:30 p.m.

Rising health insurance premiums. Higher divorce rates. Blended families.  What do they share in common?  All are reasons why more health plan clients are verifying who among their employees and dependents are rightful benefits holders.

In recent years, dependent eligibility audits have shot up in prevalence in an attempt to control the rising expense of health insurance. Now there’s a new wrinkle in the mix: the Affordable Care Act, passed in 2010, which requires group health plans to continue making coverage available for children until the age of 26 regardless of marital status.

With additional dependents now eligible for coverage, the business case for dependent eligibility verification is stronger than ever. On average, employers find at least 3% to 6% of their covered dependents are ineligible for health benefits – a financial burden that can be quickly and significantly reduced with periodic dependent eligibility verification.

An unrealized opportunity exists for health plans to offer dependent eligibility services to their ASO and fully insured clients in an effort to control premiums and deliver greater customer value. This session explores the business case for health plan-directed dependent eligibility verification as a part of a customer-centric and holistic healthcare cost containment strategy.  What roadblocks should health plans expect by developing this new service?  What ROI and other benefits can be derived?  Learn about the rewards that dependent eligibility can offer health plans and their customers and ways to navigate potential obstacles.

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Discovery Health PartnersNational Other Party Liability Group (NOPLG) 2012
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Healthcare claim recoveries jump with Discovery Health Partners

ROLLING MEADOWS, IL (July 13, 2011) – Discovery Health Partners, a provider of cloud-based healthcare cost containment solutions, today announced that it has successfully improved claims recoveries for all customers who have implemented its Intelligent Full Service Subrogation and Overpayment solutions – even driving a recovery increase of 40%  for one customer.

Since its 2008 founding, Discovery Health Partners has broken new ground within healthcare cost containment by launching the industry’s first purely cloud-based platform that offers Subrogation, Dependent Eligibility Verification, Coordination of Benefits and Information Analytics solutions in a fully outsourced model or via SaaS (pay-as-you-go) for in-house management – or in any combination in between.

“Traditional recovery and overpayment methods are antiquated, slow, complex and opaque. Analytics and cloud computing are driving a major wave of change in healthcare cost containment, and we’re at the forefront of it,” said Paul Vosters, President and COO of Discovery Health Partners. “Greater visibility and transparency enable organizations to monitor, control and improve their programs and those of their vendors. This insight is essential for better recoveries and operational savings.”

Discovery Health Partners’ customers include national and regional health insurers, healthcare providers, and self-funded organizations such as Humana, Lovelace Health Plan, Meritor, The Mentor Network and Rush System for Health, among others.

The intelligent platform enables customers to monitor their recovery operations more closely, manage other vendors on a single platform, and even compare their recovery operations to others through industry benchmarking. Three proprietary applications – Discovery Identification℠, Discovery Case Manager℠ and Discovery Dashboard℠ — identify cases for investigation; provide start-to-finish case management tools; and offer interactive analytics for visibility into current cases, real-time and historical views, and a range of customizable reports.

Rapid scalability is an additional benefit of Discovery Health Partners’ cloud platform. Within three weeks, Discovery Health Partners successfully began processing claims for a major national health plan with five million lives. The platform also supports massive data growth as Discovery Health Partners approaches petabyte-level claims analysis.

“We’ve raised the bar for methods in healthcare and benefits cost containment,” said Vosters. “Savvy organizations today expect higher standards for transparency, advanced analytics and reporting, and flexible delivery in healthcare recovery.”

 

 

 

 

 

 

 

 

 

 

 

 

 

Discovery Health PartnersHealthcare claim recoveries jump with Discovery Health Partners
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