Recovery Specialists
Healthcare Recoveries serves clients in all 50 states. Our experienced staff of more than 600 includes Property and Casualty Insurance Experts, Attorneys, Registered Nurses, Business Claims Analysts, Certified Coders and Professional Collectors. Our staff has the in-depth knowledge necessary to deliver superior results to every type of healthcare payor — from HMOs to IPAs to self-insured groups. Since 1988, Healthcare Recoveries’ highly trained staff has recovered more than $2 billion for our clients!
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) has had a significant impact on the healthcare industry. While these rules are intended specifically for healthcare payors, providers and “clearinghouses,” they also apply to business associates, including Trover Solutions, Inc. (Trover) and its divisions. As a business associate of its clients, Trover Solutions is dedicated to creating a successful plan to ensure compliance with HIPAA while maintaining the flexibility to meet the unique needs of each of our clients.
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Control Data Controlling claims data sets the recovery process in motion. Healthcare Recoveries requires only one data feed from our clients to perform all our recovery services. Using logic built into our systems, we customize the data selection criteria for your health plan. As a result, your involvement in the recovery process is minimized — allowing you to focus on your health plan’s core business. |
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Identify Cases Our proprietary data mining process is key to identifying potential recoveries — whether they are related to Overpayment Recovery, Provider Bill Audit or Subrogation. We electronically review all your paid claims, focusing on those with the highest probability of recovery. The result is more recovery opportunity for your health plan. |
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Investigate Healthcare Recoveries discovers missing file information through a series of comprehensive investigation techniques. Our Call Center staff are held to optimum industry response standards and are continually monitored to ensure they are courteous and respectful in all their interactions with your members. |
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Apply Knowledge Our expert staff are dedicated to their core competency every day — experienced Business Claims Analysts and Collectors work COB and Overpayment recoveries; Registered Nurses work Hospital Bill and DRG Audits; Certified Professional Coders work Physician Bill Audits and Provider Bill Reviews; Property and Casualty Insurance Experts and Attorneys work Subrogation cases. |
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Report & Remit Healthcare Recoveries delivers monthly net recoveries along with comprehensive reports to meet your internal reporting requirements. |
