Insurance Subrogation – Maximizing Healthcare Recoveries

Insurance subrogation services enable payors in the healthcare industry to recover millions of dollars in over paid claims each year. In order to ensure a payor is in fact maximizing their recovery potential there are a number of steps to be taken. Hiring an expert subrogator, with extensive knowledge and experience in the healthcare subrogation process, is vital to reaching that potential.

Data and Analysis Collection: 
Data collection and thorough analysis is the first step in insurance subrogation. To begin the process a subrogator will review data files of all paid claims in order to identify claims with recovery potential. It is extremely important that a thorough analysis of all paid claims takes place in order to catch all instances of over payment.

Identify and Investigate Accidents Claims 
All potential accident-related claims are also identified and investigated for incidents of overpayments. Each accident related claims should be reviewed based upon predetermined protocols. The insurance subrogator will then work with the payor’s customer service team to document the details of each claim.

File Reviews 
The insurance subrogation provider then turns the collected data over to a team of claims examiners and legal professional to review each case individually. Once all cases of overpayment have been identified the recovery process begins.

Negotiation and Settlement 
Having a team of experienced claims examiners and experts in the field of insurance regulation is essential to success in the insurance subrogation negotiation process. The insurance subrogation provider works to recover the maximum amount of compensation for each and every case of overpayment that has been identified through negation as well as litigation.

Remittance of Recoveries 
Finally the insurance subrogator prepares and delivers a comprehensive report of all payment recoveries with detailed accounts of each individual case. All recoveries are then remitted to the payor.

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