It’s Time to Take Another Look.
In the past, insurers have paid claims that should have been covered by workers’ compensation. Identifying the other coverage was difficult and time-consuming, and often simply not worth the effort.
Today, HMS offers a workers’ compensation recovery solution that makes recoveries worth pursuing. We begin with target identification, using predictive modeling, data matching, current codes, and terminology in addition to any prior matching and claim history.
Once improper claims are found, they go into Maestro, our custom-built, proprietary case management system. They are examined through both manual and automated processes as necessary, moving all the way through to recovery.
Is it worth it? We estimate that existing HMS workers’ compensation recovery services customers will save 50 cents to $1.20 per member, per year. New clients might see even better initial results, since some states allow lookback periods of up to five years, quadrupling the number of recoveries in the first year.
If all of this sounds less like business as usual and more like a better way to address workers’ compensation recovery, you’re right. By providing the broadest range of cost containment solutions available in healthcare, HMS is finding new ways to help payers like you improve performance.
Get in touch with HMS and find out an easier, more cost-effective solution to workers’ compensation recovery.