Additional resources

Case study: Western region Blues health plan modernizes its subrogation operations

Intelligent subrogation at work 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,

Settlements approach $3.5 million from cloud-based cost containment solution

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

Community health plan boosts subrogation and COB savings by more than $2 million in seven months

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

White Paper: Innovations for Cost Containment for Healthcare Payers

Get more from your cost containment efforts 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

Business Case: the SaaS [r]evolution in healthcare recovery

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

Whitepaper: dependent eligibility verification

8 reasons why it makes more sense than ever   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

Useful Resources

The following industry resources may be useful to Health Plans, Self-insured Employer Groups, HMO and Indemnity Insurers, Third-Party Administrators and Government Health Plans. The National Association of Subrogation Professionals Self-Insurance Institute of America, Inc. America’s Health Insurance Plans U.S. Government Healthcare Reform The Data Warehousing Institute Employer Healthcare Congress Health Data Management online