Discovery Health Partners tackles subrogation transformation initiative, achieves 20% more recoveries for clients

ITASCA, IL (April 30, 2019) – Discovery Health Partners today announced a 20 percent growth in subrogation recoveries for its clients from 2016-2018 and is looking to more than double those results in 2019. This increase is due to Discovery’s strategic four-pronged subrogation transformation initiative spanning its people, process, data, and technology components.

People: Discovery has made significant investments in key subro leadership positions, including the appointment of a new Vice President of Subrogation Operations, Heather Rodemann. It has increased it paralegal staff by 10% and has moved to a remote, national workforce in order to have access to superior talent. In addition, the company expanded its training program to include enhanced negotiation tactics.

Process: Procedural enhancements include a leadership role dedicated to efficiency and automation; stronger alignment of resources with cases based on skills and case complexity; and standardization of KPIs to improve consistency, best practices, and efficiency. The company’s quality audit program boasts scores of 99 percent for financial audits and 97 percent for procedural audits.

Data: Discovery has increased the variety and number of data sources it accesses with its proprietary machine learning and predictive analytics processes, including claims, eligibility, and provider data, as well as external third-party data providers. These enhancements help to identify and validate subrogation claims faster and more accurately. A multi-variant approach to diagnosis codes helps identify cases that otherwise might be missed.

Technology: Discovery has also fine-tuned its technology platform, including a HITRUST CSF® certified file transfer system and improvements to Discovery Case Manager, which guides the case investigation and recovery process, maintains a record of all activity and correspondence, and provides 24×7 visibility into subrogation case inventory and progress.

“Being able to identify and validate recoveries faster, with more accuracy, and with less member outreach further solidifies Discovery’s Subrogation solution as a best-in-class model for the industry,” stated Heather Rodemann, Vice President of Subrogation Operations. “It has been incredibly rewarding to see our team’s hard work and planning result in growth at Discovery and in more significant and accurate recoveries for our clients.”
Discovery is also making improvements to key areas of its Subrogation solution including enhanced pre-payment capabilities. Click here for additional information on Discovery and its Subrogation capabilities.

About Discovery Health Partners

Discovery Health Partners’ mission is to deliver unique, actionable analytic insights and technology-powered solutions to help healthcare payers improve payment integrity, increase revenue optimization, and maximize efficiencies with government programs. Serving more than 60 health plans across the U.S., including six of the 10 largest U.S. health plans, Discovery has been recognized consistently for its growth—earning a spot on the Inc. 5000 list five years in a row and the Crain’s Fast 50 three times. For more information on Discovery Health Partners, go to www.DiscoveryHealthPartners.com.

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Discovery Health PartnersDiscovery Health Partners tackles subrogation transformation initiative, achieves 20% more recoveries for clients
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Discovery Health Partners drives millions in recoveries and revenue optimization for Lovelace Health Plan

Analytics-based subrogation, COB and eligibility services improve health plan’s visibility, reporting and reduction of claims payment errors

ITASCA, IL (April 28, 2014) – Discovery Health Partners’ cost containment support for New Mexico-based Lovelace Health Plan has resulted in $16 million in recoveries and revenue optimization in two years, announced the company.

A mid-sized health plan, Lovelace has realized nearly $7 million in subrogation and COB recoveries working with Discovery Health Partners. These savings are the result of improved data mining, analytics, and modernized workflow available through Discovery Health Partners’ Intelligent Cost Containment Platform, which allows quick and accurate identification of cases for recovery.

By adding Medicare Secondary Payer (MSP) validation and premium restoration – a service that helps Medicare Advantage plans quickly and accurately validate MSP records, correct inaccurate records, and restore underpaid premium dollars – Lovelace has recovered an additional $7.1 million. A majority of these restorations were found within 120 days, with future revenue optimization forecast at $4.2 million annually.

“It’s a critical time for healthcare organizations to improve efficiency and performance. Discovery Health Partners’ reporting and analytics provided greater visibility into cases and trending. We also are impressed with how well their team partnered with ours,” said Karen Eskridge, Chief Operations Officer, Lovelace Health Plan. “Since working with Discovery Health Partners, we’ve pursued new savings, recovery and cost avoidance opportunities, improving our bottom line very quickly.”

Lovelace also engaged Discovery Health Partners for a Cost Containment Blueprint consulting engagement, which identified additional opportunities for cost savings and revenue generation.

“We look holistically at every health plan client’s cost containment program. Each has its own unique challenges and requirements, which our customized plans reflect,” said Paul Vosters, President and Chief Operating Officer, Discovery Health Partners. “Time and again, our clients say they value our flexible approach, partnership, and leading-edge case management and reporting tools.”

 

 

 

 

 

 

 

 

 

 

 

 

 

Discovery Health PartnersDiscovery Health Partners drives millions in recoveries and revenue optimization for Lovelace Health Plan
read more

Discovery drives millions in recoveries for Lovelace Health Plan

Analytics-based subrogation, COB and eligibility services improve health plan’s visibility, reporting and reduction of claims payment errors

ITASCA, IL (April 28, 2014) – Discovery Health Partners’ cost containment support for New Mexico-based Lovelace Health Plan has resulted in $16 million in recoveries and revenue optimization in two years, announced the company.

A mid-sized health plan, Lovelace has realized nearly $7 million in subrogation and COB recoveries working with Discovery Health Partners. These savings are the result of improved data mining, analytics, and modernized workflow available through Discovery Health Partners’ Intelligent Cost Containment Platform, which allows quick and accurate identification of cases for recovery.

By adding Medicare Secondary Payer (MSP) validation and premium restoration – a service that helps Medicare Advantage plans quickly and accurately validate MSP records, correct inaccurate records, and restore underpaid premium dollars – Lovelace has recovered an additional $7.1 million. A majority of these restorations were found within 120 days, with future revenue optimization forecast at $4.2 million annually.

“It’s a critical time for healthcare organizations to improve efficiency and performance. Discovery Health Partners’ reporting and analytics provided greater visibility into cases and trending. We also are impressed with how well their team partnered with ours,” said Karen Eskridge, Chief Operations Officer, Lovelace Health Plan. “Since working with Discovery Health Partners, we’ve pursued new savings, recovery and cost avoidance opportunities, improving our bottom line very quickly.”

Lovelace also engaged Discovery Health Partners for a Cost Containment Blueprint consulting engagement, which identified additional opportunities for cost savings and revenue generation.

“We look holistically at every health plan client’s cost containment program. Each has its own unique challenges and requirements, which our customized plans reflect,” said Paul Vosters, President and Chief Operating Officer, Discovery Health Partners. “Time and again, our clients say they value our flexible approach, partnership, and leading-edge case management and reporting tools.”

 

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To learn more about Discovery Health Partners and our solutions, please visit one of our resource pages or complete our contact request form to speak with a Business Development Director.

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Discovery Health PartnersDiscovery drives millions in recoveries for Lovelace Health Plan
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