Outreach Services

Third-Party Liability Accounts

Contractual Considerations

When a third party negligently injures a patient with health insurance, hospitals may be able to maximize payment on their charges by filing a healthcare-provider lien. Outreach Services can help. Our expertise in reviewing provider agreements allows us to quickly determine whether the hospital has a right to pursue such a lien in addition to, or in lieu of, billing the patient’s health insurance company.
Our attorneys also assist hospitals in collection from third-party payers, and can draft provider agreements that will enable the hospital to better enforce lien rights against the liable party’s insurance.

Claims Identification

Outreach Services has a number of ways to identify claims that have potential for reimbursement from a third-party payer. We use our proprietary Optima system to generate reports that accurately evaluate claims. We review medical records manually. And we conduct in-depth interviews with patients and their families.
Our reports provide an efficient and objective way to identify injury and accident-related accounts. They are designed to segregate certain account types, such as motor vehicle accidents, which require further investigation to determine potential for reimbursement.

Discovery Processes

To determine if a third party is liable, it is necessary to conduct in-depth research into the injury or accident. This includes medical documentation review, patient interviews, investigation of any law-enforcement reports related to the case, review of any relevant insuring agreements, and determination of whether establishing the liability of the tortfeasor is necessary. If third-party liability exists, count on Outreach Services to find it.

Resolution Techniques

To help providers assert their right to reimbursement from the liable party or insurer, Outreach Services employs the use of protective medical liens, creditor’s actions, and inter-company arbitration. Protective medical liens are filed against potential settlement money received by the patient as a direct result of their injury. They give providers the ability to collect reimbursement directly from the settlement award, rather than relying upon the patient to satisfy their medical debt. Creditor’s actions are filed against insurance companies who fail to honor a medical provider’s lien.
Inter-company arbitration forums and legal appeals are also used to settle disagreements over damages and liability, resulting in dispositions that favor a provider’s ability to collect reimbursement.
Another crucial resolution tool is the comprehensive review and understanding of healthcare providers’ contracts with payers. This establishes a provider’s ability to bill liable parties upfront, rather than having to wait on the costly, back-end subrogation process.

We’re here to ensure that you get reimbursed.

Increasing your Revenue

Outreach Services provides complete revenue cycle solutions to healthcare providers—maximizing reimbursement for difficult accounts. From uncompensated-care management, to managed-care claims audits, our services are geared to improve revenues, while supporting the role of hospitals as community service providers.
To learn more about our comprehensive suite of Revenue Cycle solutions, please contact us.