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.
