COMPSPEC - Third Party Liability Program

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Third Party Liability Program

COMPSPEC’s Comprehensive Third Party Recovery Program is a well established and successful program employing several distinct means of identifying potential third party liability cases and the resources necessary to bring each case to resolution. COMPSPEC’s Comprehensive Third Party Recovery Program consists of four specific services each of which is described below. This program has been designed in such a manner as to have little to no disruptive effect on the client’s staff nor demand upon client resources.

RETROSPECTIVE REVIEW AND RECOVERY SERVICES

¨ ACCOUNT SCREENING - COMPSPEC proposes to conduct a retrospective review of closed patient accounts (both inpatient and outpatient), for the purpose of identifying all accounts evidencing potential third party responsibility. The retrospective review procedures will identify opportunities to recover the client’s charges from responsible third parties where the CLIENT has taken substantial reductions in reimbursement from its usual and customary full charges and fees.

This program will utilize information (such as ICD-9 diagnostic codes and payment history) secured from the CLIENT’s patient accounts database to identify accounts for further investigation relevant to third party responsibility. Where potential third party recovery opportunities are identified, COMPSPEC staff will conduct further research and investigation on an account-by-account basis in order to secure the statutory lien and/or otherwise maximize the CLIENT’s reimbursement.

¨ INVESTIGATION & FOLLOW-UP - COMPSPEC employs a widely respected collections and skip tracing system that may be used to locate patients or other responsible parties. Wherever possible COMPSPEC will contact patients’ attorneys directly; however, when necessary, COMPSPEC may contact patients to identify their legal representatives and/or to secure permission to access police reports and other pertinent documents and information helpful to the pursuit of recoveries. COMPSPEC may also access court records.

REVIEW OF SUBPOENAS AND REQUESTS FOR RECORDS

¨ COMPSPEC proposes to conduct a review (both retrospectively and on an ongoing basis) of all subpoenas and requests for medical records and/or bills received by the CLIENT, as an additional effort to identify potentially liable third parties. In appropriate cases, COMPSPEC may recommend the subpoena or request be copied to the CLIENT’s Risk Manager or Counsel in the event of a potential allegation of medical malpractice, etc.

CONCURRENT REVIEW AND RECOVERY SERVICES

¨ COMPSPEC also proposes to conduct a concurrent program to screen open self-pay accounts, inpatient and outpatient, in an effort to identify potential third party liability cases. This procedure will include review of information similar to that described above for the Retrospective Review and Recovery Services, but as well will include training for the CLIENT’s admissions and registration staff, financial counselors, and billing and collections staff to ensure early identification of potential third party recovery accounts.

Copyright(c) 2006 CompSpec Inc.