Third Party Liability Archives - Page 2 of 2

13 Jun How Rx Claims Trigger OHI Discovery & Cost Avoidance

Posted at 13:50h in Third Party Liability

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...

29 Jul GAO Finds Medicaid Needs to Boost Third Party Liability Initiatives

Posted at 21:44h in Third Party Liability

Why GAO Did This Study During fiscal year 2013, Medicaid - collectively funded by states and the federal government - delivered health care insurance coverage to over 70 million people at an overall cost of about $460 billion. Our lawmakers generally established Medicaid as the health...

29 Jun State Medicaid Third Party Liability Cost Avoidance Q & A

Posted at 21:43h in Third Party Liability

Recently, I got into a discussion with a state Medicaid TPL director about RFPs for third party liability cost avoidance work. I feel that our cost avoidance solution would greatly benefit state-run plans, but RFPs are nearly always written for a single vendor to handle an assortment of...

05 Aug Insights on How the Medicaid Management Information System Makes Use of TPL Data

Posted at 12:59h in Third Party Liability

Third parties are organizations or people who are legally liable for paying the healthcare claims of Medicaid beneficiaries. Federal legislation and policies mandate states to guarantee that Medicaid is to be the payer of last resort. Medicaid beneficiaries are consequently obligated to utilize all other...

28 Jul 57% of Improper Medicaid Payments Due to TPL Identification Issues

Posted at 10:02h in Medicaid

With the increased awareness that government officials have paid to the need for accurate Medicaid claims information within federal government healthcare systems, one may have expected that now, nearly two years since an inspector general testified that much of the data used to identify improper...

04 Jun Syrtis Solutions’ ProTPL – Cost Avoidance for Payers of Last Resort

Posted at 16:41h in Third Party Liability

Syrtis Solutions developed ProTPL, a real-time point of sale cost avoidance service for the payer of last resort market. ProTPL offers the most active and current primary pharmacy coverage information from any vendor in the market. Up to 4 times more coverage information! ..and in real-time, at...

19 May Critical Steps to Curtail Medicaid Fraud

Posted at 20:53h in Medicaid

The watchdog for the U.S. Congress, the Government Accountability Office (GAO), designates Medicare and Medicaid as a high-risk plans, because it’s a complicated program, which is in danger from fraudulent activity. Fraud, in this case, involves deception resulting in a profitable gain at the expense...

04 Nov Syrtis Solutions To Attend the 2013 Anti-Fraud Expo coordinated by the National Health Care Anti-Fraud Association

Posted at 18:49h in Medicaid, Payers of Last Resort, Third Party Liability

Syrtis Solutions is pleased to be an exhibitor and presenter at the 2013 Anti-Fraud Exposition coordinated by the National Health Care Anti-Fraud Association. Established in 1985 by multiple private health insurers and federal and state government executives, the National Health Care Anti-Fraud Association is definitely...

Third Party Liability Tag