30 Jun Why “Pay and Chase” when you can cost avoid?
It’s not easy to discover primary commercial coverage on your plan’s members at the point of sale—costing you time and money chasing reimbursements for claims that others should have paid. And so far with little luck: on average less than 17% of the money billed to primary insurers is recovered by Medicaid plans that paid claims in error.
Why pay for other health insurance data you can’t use? ProTPL delivers timely intelligence you can act on—not a mass of information.
When ProTPL discovers other health insurance, you can reverse the latest claim and ensure that future claims, whether pharmacy or medical, aren’t paid in error. Discovering other health insurance fast, triggered by Pharmacy claims, allows you to intercept the medical claims, such as office or ER visits, that nearly always follow upon a pharmacy claim. When those new claims arrive, high-quality eligibility data cross-walked between pharmacy and medical mitigates the need for “pay and chase.”
ProTPL swiftly identifies commercial coverage that other vendors are unable to find. Our customers see an average 25% increase in other health insurance discovery. Your claims are checked against a master patient index of over 280 million commercially covered lives—the largest and most complete database of active healthcare coverage information in the nation. This means you get the best and latest eligibility responses when you need them—saving you the costs of recovery.
The first step to gaining insight into how this program will benefit your organization is for Syrtis Solutions to conduct a free quantitative claims analysis, so that we can, in empirical terms, show you exactly how much your organization can save!