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28 Oct 80% Medicaid Payments Lost Due to Poor Recovery Methods

Posted at 18:14h in Medicaid

A September 2001 report entitled “Medicaid Recovery of Pharmacy Payments by Liable Third Parties” by the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), who is charged with protecting healthcare cost containment and the integrity of HHS programs, found that...

15 Oct GAO Foresaw Need to Assist States in Recovering TPL Monies

Posted at 21:09h in Medicaid, Third Party Liability

In September 2006, after the Deficit Reduction Act of 2005 (DRA) was signed into law, the Government Accountability Office (GAO), which is the investigative arm of the U.S. Congress established to support Congress in improving performance and accountability of the federal government to the nation’s...

04 Oct Inspector General 2013 Report Shows Increased TPL Savings

Posted at 16:41h in Deficit Reduction Act, Health and Human Services, Medicaid, Third Party Liability, Uncategorized

A January 2013 report on healthcare cost containment from the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) entitled Medicaid Third-Party Liability Savings Increased, But Challenges Remain describes a substantial increase in the collection of third-party liability (TPL)...

13 Sep Effective TPL Plan Components That Ensures Cost Avoidance

Posted at 19:13h in Coordination of Benefits, Deficit Reduction Act, Medicaid, Payers of Last Resort, Third Party Liability

In the previous postings, we discussed the three main "practices" states should adopt in order to cost avoid and save taxpayer money. For states to have a truly effective TPL plan, timely discovery of any additional coverage is needed at the time of Medicaid enrollment....

05 Sep State Practice 3: Mandate Timely Processing of Claims

Posted at 19:01h in Deficit Reduction Act, Medicaid, Payers of Last Resort, Third Party Liability

Put Some Sense into Processing Claims in a Timely Manner The practice of an MCO or Medicaid billing a health insurance provider is backwards. It’s really the responsibility of the commercial insurer to make the initial payment, so that insurance claims are not delayed, which is...

29 Aug State Practice 2: Identifying TPL Insurers

Posted at 20:58h in Deficit Reduction Act, Medicaid, Payers of Last Resort

This is the second post in a three part series in which we discuss what steps states should follow to develop an effective TPL plan. In part one, we discussed the need for insurers to cooperate in the active identification of other coverage. In this...

23 Aug State Practice 1: Insurer Cooperation

Posted at 23:45h in Medicaid, Payers of Last Resort, Third Party Liability

For any state to gain an effective TPL plan, immediate and effective discovery of additional coverage is needed at Medicaid enrollment. Also, cost avoidance discovery must take on immediacy when claims are made and past mistakes need to be solved quickly. What works best is...

28 Oct 80% Medicaid Payments Lost Due to Poor Recovery Methods

15 Oct GAO Foresaw Need to Assist States in Recovering TPL Monies

04 Oct Inspector General 2013 Report Shows Increased TPL Savings

13 Sep Effective TPL Plan Components That Ensures Cost Avoidance

05 Sep State Practice 3: Mandate Timely Processing of Claims

29 Aug State Practice 2: Identifying TPL Insurers

23 Aug State Practice 1: Insurer Cooperation

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Blog

28 Oct 80% Medicaid Payments Lost Due to Poor Recovery Methods

15 Oct GAO Foresaw Need to Assist States in Recovering TPL Monies

04 Oct Inspector General 2013 Report Shows Increased TPL Savings

13 Sep Effective TPL Plan Components That Ensures Cost Avoidance

05 Sep State Practice 3: Mandate Timely Processing of Claims

29 Aug State Practice 2: Identifying TPL Insurers

23 Aug State Practice 1: Insurer Cooperation

13 Aug Federal Third Party Liability Requirements

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LINKS

Newsletter Sign-Up