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1 07.03.2003 Let GreenFlag resolve them! Presented by: Bob Weiss 1-866-Bob-Weiss Do Slow-pay Insurance Claims Make you see red?
1 07.03.2003
Let GreenFlag resolve them!
Presented by:Bob Weiss
1-866-Bob-Weiss
Do Slow-pay Insurance Claims Make you see red?
2 07.03.2003
GreenFlag Insurance Resolution•Transworld Systems is the leader in providing medical
practices with better tools for recovering slow paying accounts and expediting reimbursement from insurance companies.
– $650 million recovered for our clients last year
– More than 33 years experience recovering slow-pay and delinquent accounts
– 140 offices throughout the U.S.
FROM TRANSWORLD SYSTEMS INC.
3 07.03.2003
Transworld and the Medical Industry:Professionals Working with Professionals•Transworld has been a professional partner to the
medical practice industry for more than 10 years. •We are proud to be an MGMA AdminiServeSM Partner
and have been serving MGMA members for more than five years.
•We are a member of ACMPE.•We are HIPAA-compliant.•We currently work with over 20,000 medical facilities
nationwide
You can be confident we know your business.
4 07.03.2003
Time is not on your side…•80% of all revenue for most hospitals
and medical practices comes from insurance claims filed electronically or manually.
•Delays in payment cause frustration and restrict cash-flow.
•GreenFlag Insurance Resolution is a revolutionary new tool to assist in the rapid resolution of these claims.
5 07.03.2003
Symptom: Delay in claim resolutionPossible causes:• Incorrect information•Missing codes, signature, etc.•Money applied to deductible• Insurance checks released to patients• Insurance companies simply holding
on to your money as long as possible•“Claims never received”•Claims held in “Review”
6 07.03.2003
Internal complications…•Rising internal recovery costs and FTE expenses•Continued depreciation of old claims•Coordination of benefits with primary or secondary
provider•Billing staff tendency towards concentration on current
claims after numerous attempts to recover older claims have failed
•Continued restriction of cash flow
7 07.03.2003
1 2 3 4 5 7 9 10 15 20
250 500 750 1000 1250 1750 2250 2500 3750 5000
$2,500.00 $5,000.00 $7,500.00 $10,000.00 $12,500.00 $17,500.00 $22,500.00 $25,000.00 $30,000.00 $50,000.00$2,625.00 $5,250.00 $7,875.00 $10,500.00 $13,125.00 $18,375.00 $23,625.00 $26,250.00 $31,500.00 $52,500.00$2,750.00 $5,500.00 $8,250.00 $11,000.00 $13,750.00 $19,250.00 $24,750.00 $27,500.00 $33,000.00 $55,000.00$2,875.00 $5,750.00 $8,625.00 $11,500.00 $14,375.00 $20,125.00 $25,875.00 $28,750.00 $34,500.00 $57,500.00$3,000.00 $6,000.00 $9,000.00 $12,000.00 $15,000.00 $21,000.00 $27,000.00 $30,000.00 $36,000.00 $60,000.00$3,125.00 $6,250.00 $9,375.00 $12,500.00 $15,625.00 $21,875.00 $28,125.00 $31,250.00 $37,500.00 $62,500.00$3,250.00 $6,500.00 $9,750.00 $13,000.00 $16,250.00 $22,750.00 $29,250.00 $32,500.00 $39,000.00 $65,000.00$3,375.00 $6,750.00 $10,125.00 $13,500.00 $16,875.00 $23,625.00 $30,375.00 $33,750.00 $40,500.00 $67,500.00$3,500.00 $7,000.00 $10,500.00 $14,000.00 $17,500.00 $24,500.00 $31,500.00 $35,000.00 $42,000.00 $70,000.00$3,625.00 $7,250.00 $10,875.00 $14,500.00 $18,125.00 $25,375.00 $32,625.00 $36,250.00 $43,500.00 $72,500.00$3,750.00 $7,500.00 $11,250.00 $15,000.00 $18,750.00 $26,250.00 $33,750.00 $37,500.00 $45,000.00 $75,000.00$3,875.00 $7,750.00 $11,625.00 $15,500.00 $19,375.00 $27,125.00 $34,875.00 $38,750.00 $46,500.00 $77,500.00$4,000.00 $8,000.00 $12,000.00 $16,000.00 $20,000.00 $28,000.00 $36,000.00 $40,000.00 $48,000.00 $80,000.00$4,125.00 $8,250.00 $12,375.00 $16,500.00 $20,625.00 $28,875.00 $37,125.00 $41,250.00 $49,500.00 $82,500.00$4,250.00 $8,500.00 $12,750.00 $17,000.00 $21,250.00 $29,750.00 $38,250.00 $42,500.00 $51,000.00 $85,000.00$4,375.00 $8,750.00 $13,125.00 $17,500.00 $21,875.00 $30,625.00 $39,375.00 $43,750.00 $52,500.00 $87,500.00$4,500.00 $9,000.00 $13,500.00 $18,000.00 $22,500.00 $31,500.00 $40,500.00 $45,000.00 $54,000.00 $90,000.00$4,625.00 $9,250.00 $13,875.00 $18,500.00 $23,125.00 $32,375.00 $41,625.00 $46,250.00 $55,500.00 $92,500.00$4,750.00 $9,500.00 $14,250.00 $19,000.00 $23,750.00 $33,250.00 $42,750.00 $47,500.00 $57,000.00 $95,000.00$4,875.00 $9,750.00 $14,625.00 $19,500.00 $24,375.00 $34,125.00 $43,875.00 $48,750.00 $58,500.00 $97,500.00$5,000.00 $10,000.00 $15,000.00 $20,000.00 $25,000.00 $35,000.00 $45,000.00 $50,000.00 $60,000.00 $100,000.00
. . . . . . . . .per year for your people to sit on hold.
$19.50$20.00
$17.00$17.50$18.00$18.50
$15.50$16.00$16.50
$19.00
$13.50$14.00$14.50$15.00
$11.50$12.00$12.50$13.00
Hourly billing clerk wage: $10.00$10.50$11.00
If your insurance billing clerk is on hold for just 3 calls per day at 20 minutes per call to follow up on just 3 claims, and if they work 50 weeks per year, you are paying . . . .
# of billing clerks:# hours on hold /
person / year:
The Hidden Cost of “On-Hold” Time
8 07.03.2003
Typical In-House Procedure:Internal Cost $20 - $27/claim
Day 1-30 31-60 61-90 91-120 121-150 151-180 181-210
HCFA 1500 or
UB92 Sent
Telephone Calls or
Send Tracers
Telephone Calls or
Send Tracers
Telephone Calls or
Send Tracers
Telephone Calls or
Send Tracers
Telephone Calls or
Send Tracers
Telephone Calls or
Send Tracers
$0.50 $2.75
$1.25
$2.75
$1.25
$2.75
$1.25
$2.75
$1.25
$2.75
$1.25
$2.75
$1.25
9 07.03.2003
GreenFlag Procedure:Two-Phase Approach
10 07.03.2003
Why GreenFlag Insurance Resolution?
•Our proven third-party demands process doesn’t just refile claims, it re-prioritizes them – resulting in swifter, more accurate resolution.
•GreenFlag is cost efficient.•GreenFlag is easy to use.•GreenFlag works!
11 07.03.2003
GreenFlag: Cost Efficient•Low average fee of less than $10 per claim.
•Low, fixed cost allows our service to be utilized on claims as early as 30-45 days past due.
•Carriers pay you directly – no waiting 30-60 days to have access to your capital.
•One practice using our process recovered more than $350,000 in the first year alone at a cost of about 1%.
12 07.03.2003
GreenFlag: Easy to Use•GreenFlag standardizes the accounts receivable
procedure:– We work the claims you choose, making A/R more
predictable and cash flow steadier.
• Insurance companies are contacted by your local Transworld office.
• Insurance carriers will call your staff, effectively reversing the line of communication.
•Claims can be easily submitted/uploaded and managed 24/7 on the internet via our ONYX Customer Portal (OCP)
13 07.03.2003
GreenFlag: It Works!•Our proven third-party demands process
delivers:– Faster claims resolution– Improved cash flow– Reduced workload
•Insurance carrier by-laws and internal policies typically require immediate response to our licensed third-party contacts.
• GreenFlag demands move responsibility for a claim from clerk to supervisor, where claims are settled more quickly.
14 07.03.2003
• Commercial Insurance
• Managed Care Plans• HMO’S• PPO’S• Medicaid • Medicare• Worker’s
Compensation
GreenFlag: Works on All Types of Claims
15 07.03.2003
The Results Say It All…• A surgical hospital submitted 265 claims totaling $622,000. In 60 days,
Transworld recovered more than $400,000 at a total cost of $2,120.
• A large, non-profit hospital assigned Transworld 120+ day-old claims totaling $584,000. Transworld recovered more than $385,000 in 75 days.
• “Since July 2001, Transworld has collected over $600,000 for our office in delinquent insurance claims with their Insurance Resolution program. The collection cost was a mere 1.1%! We’re now also using Transworld on our private pay accounts and getting 50% recovery at 2% collection cost!” ---Ruby Dust, Administrator, Surgery, Inc.
• "We've had excellent results with GreenFlag. We bought 1,000 and had our money back in six weeks. We still have some chits left and will be exhausting those over the next several months. They really did a good job with getting insurance companies to deal with old accounts and particularly the silent PPO's."
- James W. Campbell, CMPE, Practice Manager, Midwest Cardiology, PC
• “Re-directing funds previously spent on in-house collection letters and efforts improved our bottom line by increasing revenue and decreasing overhead.” -David Kirk, Administrator, Intermountain Orthopedics
• Testimony read into the Congressional record in Washington, D.C. states that TSI has recovered over $9 million dollars for VA Hospitals nationwide at a cost of only 8.3%.
16 07.03.2003
Remember…• It’s not a matter of if insurance will pay,
but when insurance will pay and at what internal cost.
•GreenFlag Insurance Resolution reduces your internal costs and lowers response time, which works to reduce the age of your receivables.
•Green Flag can also recover slow paying and delinquent self pay accounts politely yet effectively all for the same low flat fee averaging $10 per account.
17 07.03.2003
Put GreenFlag to work for you today!
The only thing you have to lose is the high cost of slow-pay insurance
claims.for more information contact:
Bob WeissDistrict Manager
Transworld Systems, Inc.1601 Belvedere Road, Suite 114E
West Palm Beach, FL 33406 561.844.4341 Office
561.601.4280 cell
