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Seeing Red Presentation,Jas

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Are Insurance companies stalling your payments. Let me show you how Transworld Systems solve this issue.
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1 07.03.2003 Let GreenFlag resolve them! Do Slow-pay Insurance Claims Make you see red?
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Page 1: Seeing Red Presentation,Jas

1 07.03.2003

Let GreenFlag resolve them!

Do Slow-pay Insurance Claims

Make you see red?

Page 2: Seeing Red Presentation,Jas

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.

– Over $1 BILLION DOLLARS recovered for our clients utilizing this tool.

– More than 40 years experience recovering slow-pay and delinquent accounts

– 125 offices throughout the U.S.

FROM TRANSWORLD SYSTEMS INC.

Page 3: Seeing Red Presentation,Jas

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 12 years.

• We are a member of ACMPE and have been PEER REVIEW approved by HFMA for the past three years. We are also a sponsored vender of AMA. The only agency in the country that is aligned with all three of these organizations.

• We are HIPAA-compliant.

• We currently work with over 25,000 medical facilities nationwide

You can be confident we know your business.

Page 4: Seeing Red Presentation,Jas

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.

Page 5: Seeing Red Presentation,Jas

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”

Page 6: Seeing Red Presentation,Jas

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

Page 7: Seeing Red Presentation,Jas

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

Page 8: Seeing Red Presentation,Jas

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

Page 9: Seeing Red Presentation,Jas

9 07.03.2003

GreenFlag Procedure:Two-Phase Approach

Page 10: Seeing Red Presentation,Jas

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!

Page 11: Seeing Red Presentation,Jas

11 07.03.2003

GreenFlag: Cost Efficient

•Low average fee of less than $12 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%.

Page 12: Seeing Red Presentation,Jas

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)

Page 13: Seeing Red Presentation,Jas

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.

Page 14: Seeing Red Presentation,Jas

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

Page 15: Seeing Red Presentation,Jas

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%.

Page 16: Seeing Red Presentation,Jas

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 $12 or less per account.


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