The Medicaid Money Muddle
Each year state Medicaid agencies unintentionally pay out billions of dollars in benefits that can and should be paid by other organizations.
But the process of reclamation billing – identifying who is really responsible for a claim, and then getting them to actually pay – is extremely problematic.
While there are a large number of vendors who say they can help, most of them don’t have access to the proper databases. Many also lack the people, processes and technology to effectively follow up on claims, even if they are able to determine the correct payer.
Finding the Primary Payer
To have an effective reclamation billing program, you need a provider who can access more than just a few databases. You need a provider who can find insurance information for anybody likely to have third-party coverage.
Benefit Recovery deploys the most comprehensive network in the entire country. Our system is simply the best possible structure for finding insurance information. We have proven again and again that Benefit Recovery is able to consistently discover more third-party insurance information than any other organization.
Payer Identification Is Just Part Of The Puzzle
Most payers are very good at reducing or even avoiding payment on claims. Benefit Recovery has spent decades building systems and training people to ensure our clients get the maximum payment they are due in the minimum amount of time.
Benefit Recovery’s comprehensive, proprietary technology enables our people to perform at their very best. Our system ensures effective follow-up, with efficient interfaces and scripting that leaves no possibility unexplored. All necessary information is accessible from one system, and any required report is available quickly and easily. In short, it’s the best system in the business, and ideal for Third Party Liability work.
Various payers, such as HMOs and PPOs, all have specific processes and procedures that require significant experience to navigate. Our people have that experience, and most have spent years in the field. In fact, our denial management specialists have an average of 14 years’ experience, so we know each payer thoroughly. In addition, our staff is highly motivated, because they are compensated based on results. To enhance performance even more, we operate in specialized teams, and each team utilizes effective mentoring programs.
Reclamation billing can be a highly complex undertaking. Each year billions of dollars are lost because revenue recovery processes lack sufficient intricacy or are difficult to consistently execute. In contrast, Benefit Recovery processes are very comprehensive, represent decades of refinement, and, with the aid of our technology, are easy for our staff to apply.