An independently run 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 protects your health plan assets and gives you control of your subrogation claims.
A selection of the cascading benefits found in a Vengroff Williams Advanced Health Plan Subrogation program is as follows:
Consolidates subrogation activities
Many large corporations use multiple healthcare administrators in order to provide adequate coverage for their employees. Since most administrators outsource their subrogation services, this results in corporations having multiple subrogation vendors. This is difficult to manage and may result in uneven application of the subrogation provisions. Vengroff Williams eliminates the risk and disconnection by providing one point of contact for all your subrogation needs. This maximizes processing settlements and remitting cash.
Administrators using outside vendors, in many cases, have to relay information back and forth to the client in order to gain approval for settlements. 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. 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.”
—Demetrius Jifunza, Vengroff Williams Advanced Health Plan Subrogation Specialist
Provides direct cash recoveries back to the client
Vengroff Williams sends cash directly to our clients. We do not issue credits against the program or mix recoveries with COB savings. Funds are remitted on a monthly basis with complete detail on individual recoveries.
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 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 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 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 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 Healthcare 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 Healthcare Subrogation team, and may reduce unnecessary settlements.
An experienced attorney is assigned to oversee all aspects of implementation and operation of the 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 will provide detailed memos to the plan or their legal staff outlining all aspects of the potential settlement. This allows the plan to make informed decisions that adhere to their own corporate standard.
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 subrogation claims. 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 involvement
One of the concerns of most corporations is the resources required to implement a subrogation program 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