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1 07.03.2003 Let GreenFlag resolve them! Do Slow-pay Insurance Claims Make You See Red?

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Do Slow-pay Insurance Claims Make You See Red?. Let GreenFlag  resolve them!. GreenFlag  Insurance Resolution. FROM TRANSWORLD SYSTEMS INC. - PowerPoint PPT Presentation

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Page 1: Let GreenFlag   resolve them!

1 07.03.2003

Let GreenFlag resolve them!

Do Slow-pay Insurance Claims Make You See Red?

Page 2: Let GreenFlag   resolve them!

2 07.03.2003

GreenFlag Insurance Resolution• Transworld Systems is the leader in providing medical practices

with better tools for recovering slow paying accounts and expediting reimbursement from insurance companies.

– $650 million recovered for our clients last year

– More than 33 years experience recovering slow-pay and delinquent accounts

– 150 offices throughout the U.S.

FROM TRANSWORLD SYSTEMS INC.

Page 3: Let GreenFlag   resolve them!

3 07.03.2003

Transworld and MGMA:Professionals Working with Professionals

• Transworld has been a professional partner to the medical practice industry for more than 10 years.

• We are proud to be an MGMA AdminiServeSM Partner and have been serving MGMA members for more than seven years.

• We are a member of ACMPE.

• We are HIPAA-compliant.

You can be confident we know your business.

Page 4: Let GreenFlag   resolve them!

4 07.03.2003

Time is not on your side…

• 80% of all revenue for most hospitals and medical practices comes from insurance claims filed electronically or manually.

• Delays in payment cause frustration and restrict cash-flow.

• GreenFlag Insurance Resolution is a revolutionary new tool to assist in the rapid resolution of these claims.

Page 5: Let GreenFlag   resolve them!

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Symptom: Delay in claim resolutionPossible causes:

• Incorrect information

• Missing codes, signature, etc.

• Money applied to deductible

• Insurance checks released to patients

• Insurance companies simply holding on to your money as long as possible

• “Claims never received”

• Claims held in “Review”

Page 6: Let GreenFlag   resolve them!

6 07.03.2003

Internal complications…

• Rising internal recovery costs and FTE expenses

• Continued depreciation of old claims

• Coordination of benefits with primary or secondary provider

• Billing staff tendency towards concentration on current claims after numerous attempts to recover older claims have failed

• Continued restriction of cash flow

Page 7: Let GreenFlag   resolve them!

7 07.03.2003

Typical In-House Procedure:Internal Cost $20 - $27/claim

Day 1-30 31-60 61-90 91-120 121-150 151-180 181-210

HCFA1500 or

UB92Sent

TelephoneCalls or

SendTracers

TelephoneCalls or

SendTracers

TelephoneCalls or

SendTracers

TelephoneCalls or

SendTracers

TelephoneCalls or

SendTracers

TelephoneCalls or

SendTracers

$0.50 $2.75

$1.25

$2.75

$1.25

$2.75

$1.25

$2.75

$1.25

$2.75

$1.25

$2.75

$1.25

Page 8: Let GreenFlag   resolve them!

8 07.03.2003

GreenFlag Procedure:Two-Phase Approach

Page 9: Let GreenFlag   resolve them!

9 07.03.2003

Why GreenFlag Profit Recovery?• Insurance carrier by-laws and internal policies typically

require immediate response to our licensed third party contacts

• Our third party demand moves the responsibility for the claim from a clerk to a supervisor, who settles the claim more quickly

• Low, fixed cost allows our service to be utilized on claims as early as 30-45 days past due.

• Insurance carriers will call your staff – effectively reversing the lines of communication

Page 10: Let GreenFlag   resolve them!

10 07.03.2003

1st Contact to Pay Center 2nd Contact to Pay Center

Page 11: Let GreenFlag   resolve them!

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GreenFlag: Easy to Use

• GreenFlag standardizes the accounts receivable procedure:

– We work the claims you choose, making A/R more predictable and cash flow steadier.

• Insurance companies are contacted by your local Transworld office.

• Claim information is submitted online and you have 24/7 access to all account information

Page 12: Let GreenFlag   resolve them!

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Remember…

• It’s not a matter of whether insurance will pay, but when insurance will pay.

• GreenFlag Insurance Resolution reduces your internal costs and lowers response time, which works to reduce the age of your receivables.

Page 13: Let GreenFlag   resolve them!

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GreenFlag: Easy to Use

Claims you can submit:

– Commercial Insurance

– Managed Care Plans

– HMO’s

– PPO’s

– Medicare

– Worker’s Compensation

Page 14: Let GreenFlag   resolve them!

14 07.03.2003

Your practice will benefit

• Using GreenFlag Profit Recovery at 45-60 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.

• Quicker resolution of claims means patients get billed faster for their share of the balance, reducing the number of outstanding self-pay issues.

• Reduced internal costs

• Happier staff.

Page 15: Let GreenFlag   resolve them!

15 07.03.2003

In Summary:

• Improved Cash Flow

• Higher Recovery on Insurance Claims

• Early Identification of Patient Obligations

• Automated Program Reduces Costs

• Effective National Presence

Page 16: Let GreenFlag   resolve them!

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The Results Say It All…

• “Since July 2001, Transworld has collected over $600,000 for our office in delinquent insurance claims with their Insurance Resolution program. The collection cost was a mere 1.1%! We’re now also using Transworld on our private pay accounts and getting 50% recovery at 2% collection cost!” ---Ruby Dust, Administrator, Surgery, Inc.

• “Re-directing funds previously spent on in-house collection letters and efforts improved our bottom line by increasing revenue and decreasing overhead.” ---David Kirk, Administrator, Intermountain Orthopaedics

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DIPLOMATIC FIRST PATIENT CONTACT

• Up to 5 demands will be sent on your behalf – start, stop and suspend activity online

• Payment Voucher and Envelope are included

• Identifies intent

• Separates patients • from debtors

• Allows patient to contact your office to make payment arrangements

• Activity reports refreshed every 24 hours

• Keeps your staff in control at all times.

PATIENT SELF-PAY PROGRAM

Page 19: Let GreenFlag   resolve them!

19 07.03.2003

“Thank You!”

Sent to Patients when their accounts are paid

in full to maintain relationship

(your option)

Page 20: Let GreenFlag   resolve them!

20 07.03.2003

Verbal Demands• When intensive recovery efforts are

required• GreenFlag Verbal Demands employs a team of highly

trained recovery specialists operating from nationwide call centers.– Verbal Demands Phase:

• Turns up the heat on overdue accounts• You pay only for what is recovered• Offers legal recourse for tough cases• Handles the types of accounts other agencies ignore as un-collectable.• Completely optional – you can cancel accounts online for any reason

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A final word…See for yourself why over 60,000 businesses choose TSI over extended in-house efforts and all other 3rd party alternatives combined •We recover three times the industry average for about one sixth the cost.

•Flat-fee, no percentages – regardless of the balance. Average cost of only 7 cents per dollar collected.

•Diplomatic approach – we recover your profits without offending your valued customers.

•You stay in control – you decide how diplomatic to be and when to turn up the heat.

•Recovered profit is paid directly to you. No more waiting 30-60 days for an agency to pay you your money.

•Over 130 Offices Nationwide – provides unparalleled local impact.

•Performance is guaranteed – Use TSI at no financial risk whatsoever.

Contact Information:

Tyler Williams – District Manager

Transworld Systems Inc.

1717 Dixie Highway Ste 490

Fort Wright, KY 41011

P. 859.331.1957

F. 859.331.0413

C. 614.208.8431

[email protected]