TPL Oversight
Develop data-driven insights with oversight on all your
third party liability related efforts.
Seeing is believing.
Managing Medicaid third party liability (TPL) efforts is crucial for maximizing recoveries, whether you outsource to a Managed Care Organization, collaborate with vendors, or handle it in-house. Without proper oversight, contracted work can leave you in the dark until funds arrive. Our TPL oversight solution provides real-time visibility into claims throughout their lifecycle, empowering your team to proactively improve processes. More than a service provider, we’re a partner committed to your success—offering complete oversight and control of TPL activities.
DASHBOARD & REPORT MONITORING
Oversee all of your recovery-related efforts for Medicaid TPL from any and all vendors, including your in-house teams, with ease.
- Conveniently monitor performance, including how much is being recovered, how many claims are pursued, how long recoveries take, what coverage is being used, how rejections are handled, and more.
- Access the most accurate and up-to-date data, empowering you to make informed decisions and optimize your recovery efforts for maximum results.
- Our robust reporting features allow you to identify trends and generate customized reports that provide actionable insights.
- Keep TPL leadership and your team updated with informative visuals to communicate key information and recovery results.
- Utilize this data to strategically identify key insurance payers in your state and optimize your focus on where you can maximize the most recoveries.
DASHBOARD & REPORT MONITORING
Oversee all of your recovery-related efforts for Medicaid TPL from any and all vendors, including your in-house teams, with ease.
- Conveniently monitor performance, including how much is being recovered, how many claims are pursued, how long recoveries take, what coverage is being used, how rejections are handled, and more.
- Access the most accurate and up-to-date data, empowering you to make informed decisions and optimize your recovery efforts for maximum results.
- Our robust reporting features allow you to identify trends and generate customized reports that provide actionable insights.
- Keep TPL leadership and your team updated with informative visuals to communicate key information and recovery results.
- Utilize this data to strategically identify key insurance payers in your state and optimize your focus on where you can maximize the most recoveries.
COVERAGE REVIEW PROCESS
Having accurate coverage to perform efficient cost avoidance is no doubt the most effective TPL recovery strategy. When it comes to large data volumes, auditing for accuracy and completion is crucial.
- No more manual checking and re-checking. Take advantage of our cutting-edge automated rules that can be tailored to your program’s definition of completeness.
- Take the guesswork out of coverage matching by effortlessly cross-checking submitted coverage against your existing MMIS data, ensuring complete accuracy at all times.
- With our custom review workflows, you can streamline your data review process like never before – and by including various submission categories, we’ll provide you with a comprehensive overview of all your data.
- Gain the upper hand in contract negotiations with our advanced platform that allows you to easily review acceptance and rejection trends, enabling you to drive discussions on terms and help you secure better contracts.
POST PAYMENT REVIEW PROCESS
Transparency in your billing process for post-payment billing is essential for maintaining financial health and operational efficiency. By understanding what claims are being billed, identifying which claims are rejected, and tracking average timelines for payment, you can make informed decisions and streamline your financial management.
- Unlock the full potential of your post payment claim reclamation billing process with our comprehensive data-sharing capabilities! Our platform integrates data from your vendors and managed care organizations, as well as connections with data from your MMIS and shared Data Warehouse which allows you to gain valuable insights into every aspect of the claim lifecycle.
- Minimize information and timeliness discrepancies while ensuring your data accuracy by cross-referencing submitted coverage against recovery efforts.
- Prevent information overloads by identifying and targeting claims the vendor and managed care organization should prioritize – keeping the amount of data shared to the absolute minimum to ensure HIPAA compliance.
- Take control of recovery payments. Create and customize your own rules to ensure accurate acceptance or denied recoveries based on business rules, contract terms, and stipulations.
- Say goodbye to the headache of tracking accounting information and worrying about compliance during audits. With our innovative technology, you can effortlessly reconcile invoicing directly against recovered claims, ensuring accurate and streamlined financial management.
POST PAYMENT REVIEW PROCESS
Transparency in your billing process for post-payment billing is essential for maintaining financial health and operational efficiency. By understanding what claims are being billed, identifying which claims are rejected, and tracking average timelines for payment, you can make informed decisions and streamline your financial management.
- Unlock the full potential of your post payment claim reclamation billing process with our comprehensive data-sharing capabilities! Our platform integrates data from your vendors and managed care organizations, as well as connections with data from your MMIS and shared Data Warehouse which allows you to gain valuable insights into every aspect of the claim lifecycle.
- Minimize information and timeliness discrepancies while ensuring your data accuracy by cross-referencing submitted coverage against recovery efforts.
- Prevent information overloads by identifying and targeting claims the vendor and managed care organization should prioritize – keeping the amount of data shared to the absolute minimum to ensure HIPAA compliance.
- Take control of recovery payments. Create and customize your own rules to ensure accurate acceptance or denied recoveries based on business rules, contract terms, and stipulations.
- Say goodbye to the headache of tracking accounting information and worrying about compliance during audits. With our innovative technology, you can effortlessly reconcile invoicing directly against recovered claims, ensuring accurate and streamlined financial management.
Feeling lost in a black box with your vendors?
Allow us to shed some light with our TPL oversight module.