Insurance Claims Resolution and Self-Pay Recovery Spend more time with patients, and less time worrying about receivables.
Transworld Systems Inc. <ul><li>In the past 5 years, we have recovered $2.5 billion for our clients </li></ul><ul><li>Over...
Time is  not  on your side <ul><li>80%  of all revenue for most hospitals and medical practices comes from insurance claim...
Symptom:Delay in claim resolution <ul><li>Possible Causes: </li></ul><ul><li>Incorrect information </li></ul><ul><li>Missi...
Internal complications... <ul><li>Rising internal recovery costs and FTE expenses </li></ul><ul><li>Continued depreciation...
Phase One Typical In House Procedures Internal Cost $20 - $27/claim
Two-Phase Approach
Why GreenFlag Profit Recovery? <ul><li>Insurance carrier by-laws and internal policies typically require  immediate  respo...
Claims you can submit: <ul><li>Commercial Insurance </li></ul><ul><li>Managed Care Plans </li></ul><ul><li>HMO’S </li></ul...
Remember: <ul><li>It is not a matter of  if  insurance will pay, but  when  insurance will pay. </li></ul><ul><li>GreenFla...
The results speak for themselves <ul><li>A surgical hospital submitted 265 claims totaling $622,000 to Transworld. In 60 d...
How do you benefit? <ul><li>Using GreenFlag Profit Recovery at 30-45 days allows your staff  to focus their attention and ...
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Insurance Resolution 6 07[1]

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Insurance Resolution 6 07[1]

  1. 1. Insurance Claims Resolution and Self-Pay Recovery Spend more time with patients, and less time worrying about receivables.
  2. 2. Transworld Systems Inc. <ul><li>In the past 5 years, we have recovered $2.5 billion for our clients </li></ul><ul><li>Over 40 years of experience recovering slow-paying and delinquent accounts. </li></ul><ul><li>More than 120 offices across the United States. </li></ul><ul><li>“ Transworld gets credit for the highest recovery rate in the industry.” </li></ul><ul><li>- Barron’s </li></ul>We’re in the business of profit recovery. We lead the industry in providing medical practices with better tools for recovering slow paying patient accounts and expediting reimbursement from insurance companies.
  3. 3. Time is not on your side <ul><li>80% of all revenue for most hospitals and medical practices comes from insurance claims filed electronically or manually. </li></ul><ul><li>Delays in payment cause frustration and restrict cash-flow. </li></ul><ul><li>GreenFlag Insurance Resolution Recovery is a revolutionary new tool to assist in the rapid recovery and resolution of these claims. </li></ul>
  4. 4. Symptom:Delay in claim resolution <ul><li>Possible Causes: </li></ul><ul><li>Incorrect information </li></ul><ul><li>Missing codes, signature etc. </li></ul><ul><li>Money applied to deductible </li></ul><ul><li>Insurance checks released to patients </li></ul><ul><li>Insurance companies simply holding on to your money as long as possible </li></ul><ul><li>“ Claims never received” </li></ul><ul><li>Claims held in “Review” </li></ul>
  5. 5. Internal complications... <ul><li>Rising internal recovery costs and FTE expenses </li></ul><ul><li>Continued depreciation of old claims </li></ul><ul><li>Coordination of benefits with primary or secondary provider </li></ul><ul><li>Billing staff tendency towards concentration on current claims after numerous attempts to recover older claims have failed </li></ul><ul><li>Continued restriction of cash-flow </li></ul>
  6. 6. Phase One Typical In House Procedures Internal Cost $20 - $27/claim
  7. 7. Two-Phase Approach
  8. 8. Why GreenFlag Profit Recovery? <ul><li>Insurance carrier by-laws and internal policies typically require immediate response to our licensed third party contacts. </li></ul><ul><li>Our third party demand moves the responsibility for the claim from a clerk to a supervisor, who settles the claim more quickly. </li></ul><ul><li>Our average fixed fee of less than $10.00 per claim allows you to utilize this unique service on claims as early as 30-45 days past-due. </li></ul>
  9. 9. Claims you can submit: <ul><li>Commercial Insurance </li></ul><ul><li>Managed Care Plans </li></ul><ul><li>HMO’S </li></ul><ul><li>PPO’S </li></ul><ul><li>Medicare </li></ul><ul><li>Workman's Compensation </li></ul><ul><li>* Automobile </li></ul>
  10. 10. Remember: <ul><li>It is not a matter of if insurance will pay, but when insurance will pay. </li></ul><ul><li>GreenFlag Profit Recovery reduces your internal costs and lowers response time, which works to reduce the age of your receivables. </li></ul>
  11. 11. The results speak for themselves <ul><li>A surgical hospital submitted 265 claims totaling $622,000 to Transworld. In 60 days we recovered over $400,000 at a total cost of $2,120. </li></ul><ul><li>A large non-profit hospital assigned 120+ old day claims to Transworld totaling $584,000. We resolved and recovered over $385,000 in 75 days . </li></ul>
  12. 12. How do you benefit? <ul><li>Using GreenFlag Profit Recovery at 30-45 days allows your staff to focus their attention and efforts on claims in the 0-30 day window. This reduces the number of claims reaching 60 days. </li></ul><ul><li>Quicker resolution of claims means patients get billed faster for their share of the balance, reducing the number of outstanding self-pay issues. </li></ul>

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