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Insurance Claims Resolution and Self-Pay Recovery Spend more time with patients, and less time worrying about receivables.

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Presentation on theme: "Insurance Claims Resolution and Self-Pay Recovery Spend more time with patients, and less time worrying about receivables."— Presentation transcript:

1 Insurance Claims Resolution and Self-Pay Recovery Spend more time with patients, and less time worrying about receivables.

2 Transworld & the Healthcare Industry: Professionals Working with Professionals Transworld has been a professional partner to the medical practice industry for more than 38 years. We are a member of ACMPE. We are the ONLY Collection Company that is an Adminiserve Partner of the MGMA ($230M Recovered, 53% Recovery Rate, 2.5% Cost as of May’07) We are the only agency that is Peer Reviewed by the HFMA We currently work with over 20,000 healthcare facilities nationwide You can be confident we know your business. * HFMA staff and volunteers determined that this product has met specific criteria developed under the HFMA Peer Review Process. HFMA does not endorse or guaranty the use of this product

3 Transworld Systems Inc. In the past 5 years, we have recovered $2.4 billion for our clients Over 30 years of experience recovering slow-paying and delinquent accounts. More than 120 offices across the United States. “ Transworld gets credit for the highest recovery rate in the industry.” - Barron’s We’re in the business of profit recovery. We lead the industry in providing medical practices with better tools for recovering slow paying patient accounts and expediting reimbursement from insurance companies.

4 GreenFlag: Cost Efficient Reduce in-house costs dramatically, by having the insurance company contact you directly. A low fixed rate that equals pennies on the dollar collected. Low, fixed cost allows our service to be utilized on claims as early as 30-45 days past due. Carriers pay you directly – no waiting 30-60 days to have access to your capital. The program works as an extension of your billing office

5 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 We contact the insurance companies on your behalf regarding unpaid claims. Since we are regarded as a third party, the insurance company must respond to you regarding the resolve of unpaid claims or their bond rating will be adversely affected. Insurance carriers will then contact your staff to provide you with the resolve on claims we submitted on your behalf. Claims can be easily submitted/uploaded and managed 24/7 on the internet via our ONYX Customer Portal (OCP)

6 Hidden Cost of On-Hold Time # of insurance follow up personnel If your insurance billing clerk is on hold for just 3 calls per day at 20 minutes per call to follow up on just 3 claims, and if they work 50 weeks per year, you are paying.... Assumption: Hourly Wage = $15.00 (including overhead) 2 Amount paid per year for employee’s to sit on hold $7,500

7 Differentiates Third Party Impact Differentiates your Claim

8 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. Our average fixed fee of less than $10.00 per claim allows you to utilize this unique service on claims as early as 30-45 days past-due.

9 Insurance resolution Month 1

10 Insurance resolution Month 2

11 Insurance resolution Month 3

12 Insurance Resolution Results: Insurance Resolution Rates CLIENTTransworldCost Average Balance Average Age (Mo) Hexxxxxxxxxxxx62.10%0.2%$4,566.343.1 Southxxxxxxxxxxxxxx65.30%0.9%$1,045.574.9 Vxxxxxxxxxx83.70%1.03%$823.965.7 Indiaxxxxxx49.70%3.5%$318.276.5

13 How do you benefit? Using GreenFlag Profit Recovery at 30-45 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.

14 Self-Pay Recovery Spend more time with patients, and less time worrying about receivables.

15 The Power of Fixed Fees How does the power of GreenFlag’s Fixed Fees work? You pay only a fixed fee for each account Fixed fees average $10* per account No percentages are taken with GreenFlag services *Company average

16 Listen to the Experts “In addition to the superior collection rate and speed of recovery, Transworld’s low fee provides the client with a 30%-70% savings.” — FORBES Magazine

17 Why do GreenFlag written demands work so well? Return address is from one of the 130 offices nationwide You choose the tone of the demand: diplomatic and more intense You have messaging options We’ll send Thank You notices upon request to help you retain valued customers The Power of Written Demands

18 The Power of Control Why is it important to be in control of submitting & withdrawing accounts? You need to be in charge because this is your business. You decide which accounts should get attention and how aggressive to be You decide when to add, delete or put accounts on hold – and we charge no penalties You check your “real time” reports 24/7 so you can make the best choices for your accounts

19 24/7 “Real Time” Reporting Client controls all starts and stops Ability to access, update, and manage accounts online Real-time, web-based account reporting 24/7 access to account information

20 GreenFlag Advantages PAY LESS GreenFlag flat fees average less than $10 per account. NET MORE MONEY No percentages taken; all recovered money sent to you RAPID RESULTS Early action by an outside party motivates payments RETAIN CONTROL 24/7 web access to manage accounts in “real time”


22 Results of aggregate Chiropractic clients Cost Per Account : $13.25 Avg Balance: $696.55 Avg Age of Accts (Months): 12.2 Recovery Rate Net Dollars Assigned: $131,111.50 % Recovery Rate on Net Dollars Assigned: 39.0% % Recovery Rate on Total Dollars Assigned: 37.5% Return on Investment Collection Cost as a % = Cost of Accounts Submitted / Total Performance 5.5% R.O.I: (based on accounts submitted to date) 1806.6% For every dollar invested, Transworld Systems returned: $18.07 For every account assigned, Transworld Systems returned: $235.62

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