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 transforms healthcare recovery with SaaS

ROLLING MEADOWS, IL (June 6, 2012) – Discovery Health Partners, a provider of intelligent healthcare cost containment solutions, today announced that a new health plan customer has successfully implemented its software-as-a-service (SaaS)-based Subrogation service.  The SaaS delivery model is an alternative to the traditional Full Service outsourcing that Discovery Health Partners has delivered to health plan and self-funded customers since 2008.

For a western region Blues health plan, Discovery Health Partners built a Virtual Private Cloud (VPC) to support and enhance the collections, insight, reporting and productivity of existing internal pre-payment and recovery Subrogation processes. In the VPC, claims data resides in Discovery Health Partners’ privately hosted, secure environment for Subrogation case identification, case management, and information analytics.

The new SaaS-based healthcare recovery model allows in-house recovery teams to benefit from state-of-the-art technology in a cost-efficient subscription model while retaining full control of the Subrogation function. It operates on Discovery Health Partners’ proprietary Healthcare Analytics Platform, which transforms key healthcare cost management business processes with enterprise-level, cloud-powered information analytics.

For a second customer, a community health plan in the northeast, Discovery Health Partners created a Hybrid Cloud environment, in which sensitive data remains in the customer data center and streams into Discovery Health Partners’ analytic applications only when needed, then returns to the customer data center. This approach represents an incremental step toward the cloud, allowing organizations to reap cloud value while retaining their data on premise.

“These examples of cloud adoption symbolize the seismic shift underway within healthcare, an industry that has long struggled with antiquated technology, overly complex processes, and a lack of information transparency,” said Paul Vosters, President and Chief Operating Officer of Discovery Health Partners. “The cloud is an enabler for competitive advantage. Our HIPAA-compliant SaaS models enable greater flexibility, cost effectiveness and control for the healthcare claims recovery and overpayment industry.”

Three robust, on-demand applications help customers tightly manage their recovery programs:

  • Discovery Identification℠, a sophisticated data mining engine that accurately generates cases for investigation;
  • Discovery Case Manager℠, which delivers modernized workflow, rich case detail, digital imaging and storage, and plan language features; and
  • Discovery Dashboard℠, which provides unprecedented visibility through customized analytics for trend and case reporting

Discovery Health Partners uses commercial cloud services from leading providers such as Amazon Web Services, Informatica, and Microsoft. It includes comprehensive application, data, and infrastructure security controls designed to facilitate security governance and manage ePHI data security. It is fully HIPAA-compliant, meeting rigorous standards for technical, physical, and administrative security.

 

 

 

 

 

 

 

 

 

 

 

 

Discovery Health PartnersDiscovery Health Partners transforms healthcare recovery with SaaS
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