In the second post in this series, I explained why a full-time “specialty” focus on healthcare subrogation is so important when evaluating and selecting a vendor. In this post, I will explain why the most effective healthcare subrogation companies are those with experience and a proven track record.
There are several ways to evaluate experience in healthcare subrogation, but, in my view, the one thing that tends to drive higher recoveries is demonstrated experience litigating healthcare subrogation matters in federal court. Why is that? Well, personal injury attorneys are a saavy group. If they think they are dealing with a company that operates like a collection agency, most personal injury attorneys know they can demand much deeper reductions.
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On the other hand, if they know that a healthcare subrogation company has litigated federal court cases in all parts of the company, including federal appellate cases, then most personal injury attorneys will pay a plan back consistent with what the plan language requires. To test the company you are considering, find out who their key attorneys are and search for them in LEXIS along with ERISA and subrogation as additional key words come up. If only a handful of cases show up, you may not be dealing with an attorney that will not gain the respect of most personal injury attorneys.
With respect to a proven track record, it is important to ask for specific results over several years from a single client with 100,000 or more covered lives. Ask for specific subrogation dollars recovered per year and divide that number by the life count. Most importantly, ask the company to provide a contact with that client company and verify.
Unfortunately, I have been told that there are healthcare subrogation companies in the marketplace that will claim high dollar recoveries per member per year (PMPY) but, when pressed, cannot back those claims up.
As always, the purpose of focusing on experience and a track record is finding a healthcare subrogation vendor that will help you move from $7.00 PMPY to $17.00 PMPY, or more.
Next time, I will discuss the importance of selecting a vendor that understands subrogation from a legal perspective.
To see a short video on my YouTube Channel about this topic, please see https://btartboxes.com/. Please subscribe to my YouTube Channel while you are there. To sign up to attend my webinar, The Five Most Costly Health Plan Mistakes Companies Make Today, please point your web browser to https://www.dstrkt-london.com/.
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