Subrogation Providers: Independent vs. Downstream-Vendors
Most organization with self-funded ERISA health plans already have a Medical Subrogation Provider (also know as Health Plan Subrogation, or Healthcare Subrogation). Providers like this usually come along with their TPA (Third Part Administrator) that they’re engaged with at the moment. But the top 10% of Health Plan Managers use Independent Subrogation Providers. Why is that? Well, here we share with you the top 6 reasons Independent Subrogation Providers are superior. Let’s see how the right subrogation provider can majorly benefit your company, union, or organization and save you big.
TPAs, Plan Admins, and Insurance Companies
Today, whether you are aware of it or not, your TPA or Plan Admin is outsourcing your subrogation claims to multiple third party vendors and it’s hurting the fitness of your health plan. Many of these down-stream vendors have relationships with insurance companies which further complicates their loyalty. And to top it off, these vendors are also aware that the standard contact length for the TPA or Admin with your organization is only between 2 and 3 years. They will continue to work with the TPA, but they know they won’t be working for you after that… Now, let’s take a look at these inefficiencies and misalignments.
Here’s What’s Happening
Down-stream vendors work for their respective claims administrator not you.
❌ – This causes a misalignment of incentives and prevents control over specific cases and a culture of procrastination within the down-stream vendor. As a result, after they stop being engaged with your organization, they get to keep the claims that are being settled down the line, years in many cases. That’s not a great look for someone who is supposed to be on your side, and its definitely not in your organization’s best interest.
Each down-stream vendor processes claims differently.
❌ – This creates confusion amongst employees and impacts morale and causes your phone to ring off the hook! And eats up your precious time answering unnecessary questions. You’re time is valuable and neither you nor your employees deserve the extra stress.
Claims revenue recovery varies from each down-stream vendor.
❌ – According to Deloitte the national average for recovery is .25% of Annual Health Plan Spend. Because of this, not only are you and your employees being adversely affected, but you’re also missing out on major health plan recoveries.
Why is a Truly Independent Subrogation Provider Important?
Independent Subrogation Providers are Not Affiliated with Insurance Companies or TPAs.
✅ – Works only for you, aligns incentives and provides control and continuity to your claims. Provides the freedom to change Claims Administrators at any time without loosing your multi-year subrogation claims. Multi-year claims are most often the highest dollar claims!
All claims management (medical, short-term disability and pharmaceutical meds)
✅ – Enabling tailored strategies that maximize your recovery
We recover up to 5x the industry average (1.0% to 1.2% of your Annual Health Plan Spend)
✅ – Get industry leading results AND customer satisfaction: We provide an Employee Hotline, custom letter options, and more to help take on the daily burden of workload, effectively reducing your daily busywork, enabling your team to focus where it’s most important.
This is just a short list of 8 reasons a truly independent subrogation provider like Vengroff Willians is extremely important to the fitness of your health plan. If you’d like to learn more or ask a question, please contact me today! I’d be happy to share some more ways to improve your health plan, save serious revenue and !