HR Best Practices

Containing Health costs through Data Mining

Subrogation

FACT:

All plans are entitled to third party liability recoveries (i.e., due to an accident or injury caused by someone else) and few plans get their respective entitlement. Note - Subrogation can account for over 2% of the medical benefits budget.

PERCEPTION:

Payors and TPAs are administering subrogation effectively and efficiently and the money is ostensibly being credited back to the plan.

REALITY:

Subrogation is generally outsourced to specialty firms. These firms generally get paid 35% of recoveries. Many of these firms only focus on high dollar claims which results in plans being short-changed.

OPPORTUNITY:

HR Best Practices has proprietary subrogation technology that routinely leads to material exposures and financial recovery/prospective savings opportunities.

HRBP In the News!

NEWSFLASH: Subrogation specialists “estimate that between 1% and 3% of health-care spending is potentially recoverable to the health plan.” Wall Street Journal, November 20, 2007 Read More (subscription required) - Learn More about Subrogation

Differentiators

Change Agents
Independence
Comprehensiveness
Technology

Audit Working Spouses

Removing working spouses or adding a spousal surcharge provision provides greater savings than a dependent audit.

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Customer Quote

Chief Internal Auditor

“HR Best Practices goes beyond the normal practice of manual sampling and testing of claims by using advanced software they have developed to do extensive data mining and analysis of your full population of claims. The HR Best Practices team is not only expert in the health care field; but the team also has a real passion for healthcare auditing and cost containment”.