Medical Subrogation Services
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An independently run medical subrogation program is designed to ensure that money is recovered and returned to your health plan no matter what changes have occurred with your health plan or administrators. Millions of dollars go unclaimed each year due to inadequate follow-up. Vengroff Williams is a premier medical subrogation vendor, protecting your health plan assets and giving you control of your medical subrogation claims. Vengroff Williams consistently outperforms competing healthcare medical subrogation companies by following our 4 core principals. Empathy, Technology, Continuity, Advocacy.
A selection of the cascading benefits found in a Vengroff Williams Advanced Medical Subrogation program is as follows:
Consolidates medical subrogation activities
Many large corporations use multiple healthcare administrators in order to provide adequate coverage for their employees. Since most administrators outsource their medical subrogation services, this results in corporations having multiple medical subrogation vendors. This is difficult to manage and may result in uneven application of the medical subrogation provisions. Vengroff Williams eliminates the risk and disconnection by providing one point of contact for all your medical subrogation needs. This maximizes processing settlements and remitting cash. An effective Medical Subrogation group makes your life as a plan manager easier, helps the plan run more efficiently, and improves employ moral.
Administrators using outside Medical Subrogation groups, in many cases, have to relay information back and forth to the client in order to gain approval for settlements. Like a game of telephone, these delays can cause a loss of revenue or complicate settlement discussions. Vengroff Williams establishes settlement authority and contacts clients directly in order to expedite recoveries in cases that exceed the established authority. Making your life easier. As medical benefits are only one portion of the corporate expenses accumulated when dealing with injuries, we work with the corporation medical plan administrator, their disability carriers and the pharmacy benefits provider to consolidate medical, self-funded disability and prescription drug expenses into one claim.
“I enjoy talking to our clients’ plan members. We help them understand our services and, in most cases, we get all the information we need just from the phone call. It puts them at ease knowing that there is someone waiting there to help.”
— Vengroff Williams Advanced Medical Subrogation Specialist
Plan language & program design consultancy
Many corporate health plans are governed by ERISA. The frequent variances in legal rulings require changes in plan language to keep up to date. We provide our clients with assistance in incorporating the strongest language possible in order to retain their medical subrogation and reimbursement rights.
Additionally, Vengroff Williams designs plans that cover multiple administrators. Corporations use more than one administrator and, in cases where there are several distinct operating companies, union plans or major geographic differences, we work to establish unique language where required and coordinate common plan language across administrators where allowed. This enables a company to tailor its medical subrogation program to accommodate collective bargaining agreements and other individual considerations that may be necessary within one corporation.
Employee correspondence letter customization
Vengroff Williams has developed a complete set of letters requesting information regarding the circumstances of an injury. This allows us to determine if there is medical subrogation potential. We work with clients to allow customization of these letters.
We also supply and require signed reimbursement agreements when the client makes this a part of their regular medical subrogation process. Employees are provided a toll-free number and postage-paid return envelopes to make responding quick and easy. In addition to written correspondence, Vengroff Williams also employs a full staff of investigators to make phone contact whenever possible in order to gain full detail of the injuries.
Assigns powerful legal experts
Industry-specialized Medical Subrogation attorneys work hard to avoid repaying the plan. Our team’s focus is to maximize the amount of money that is recovered for our clients to the fullest potential. These attempts come in various forms with a litany of legal arguments to avoid reimbursement. In many cases, claims handlers are unable to refute the arguments brought forth by the Vengroff Williams Intelligent Medical Subrogation team, and may reduce unnecessary settlements.
An experienced attorney is assigned to oversee all aspects of implementation and operation of the medical subrogation program. Paralegals are used when there is a full settlement offered. In any cases where a reduction is requested or needs to be negotiated, the attorney assigned to the client reviews each case and negotiates the settlement directly with the plaintiff’s attorney.
“We are much more comfortable with Vengroff Williams. Subrogation claims are a legal matter. It was difficult to follow our claims through our administrator’s vendor. Now, I always know our claims are being handled properly, no matter what administrators we use.”
—Director of Benefits, Fortune 500 client
Provides large-case analysis, future benefits & long-term treatment recommendations
With high-dollar losses and serious injuries, there is a great deal to consider when reviewing settlements. These considerations include the amount of settlement money available, the long-term care required, the continuation of benefits and, ultimately, the plan’s wishes for the treatment of the covered parties. Vengroff Williams legal staff represents the plan regarding all aspects of the potential settlement. This allows our attorneys to make informed decisions adhering to your corporate standards.”
Implements industry-leading ICD10 data mining
Our proprietary software identifies the broadest range of claims possible. Vengroff Williams has developed the most sophisticated sort routines in the industry to identify potential medical subrogationclaims. Our system identifies the most potential claims while minimizing unnecessary communications with your employees. We can accept all forms of data from administrators’ systems. We receive data feeds from most of the largest nationwide carriers.
Organizes reports according to the client’s internal corporate structure
Vengroff Williams provides detailed monthly reporting on remittances and detailed quarterly reporting on open and closed cases with an executive summary of activities for each quarter containing no PHI. Vengroff Williams will organize these individual reports by administrator and operating company or divisions as required by the plan. There is no charge for the customization of reports, nor are there any restrictions on the number of reports.
Direct administrator data connection eliminates staff involvementg
One of the concerns of most corporations is the resources required to implement a medical subrogationprogram with an independent vendor. With the implementation of business associates agreements, Vengroff Williams handles all aspects of data transfer directly with our clients’ administrators.
- HIPAA-Compliant Service Provider
- SSAE 18 Attestation
