It's certainly not easy to identify primary business insurance coverage with regards to your plan's members at the point of sale-- costing your company time and money tracking down reimbursements for claims that others should certainly have paid for. And thus far with little luck: generally no more than 17 % of the money billed to primary insurance carriers is actually recovered through Medicaid plans that paid off claims in error.
Why spend for additional health plan data your business simply cannot utilize? ProTPL provides prompt intelligence you will be able to act upon-- not a mass of information and facts.
As soon as ProTPL finds additional medical insurance, you can reverse the most recent claim and ensure that future claims, whether pharmacy and medical, aren't paid in error. Identifying additional medical insurance swiftly, prompted by means of Pharmacy claims, permits your company to intercept the medical claims, which include office or ER visits, that practically always follow upon a pharmacy claim. The moment those new claims turn up, high quality eligibility details cross-walked between pharmacy and medical alleviate the necessity for "pay and chase.".
ProTPL immediately identifies commercial insurance coverage that other vendors are normally not able to discover. Our users see an average 25 % boost in various other health insurance identification. Your claims are actually checked against a master patient list of over 280 million commercially covered lives; the pay and chase biggest and most complete data source connected with active health care policy coverage information in the country. This means you get the best as well as latest eligibility responses the moment you need them--sparing you the expense of recovery.
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