During this Dec.7, 2017, HFMA Forum webinar, Sasha Towne Patient, director of patient financial services at Boston Medical Center, and Michael Friedberg, vice president of strategic accounts at Parallon, shared strategies for managing third-party liability (TPL) claims.
Key takeaways from the webinar include the following:
Understand the importance of TPL claims. TPL claims typically make up 5 percent or less of hospitals or health systems’ account receivables. However, because of certain challenges (i.e., limited data collected in emergency departments, underpayments, and missed payment), these claims require specialized knowledge and processes to properly adjudicate, Friedberg says.
Address productivity. It is critical to ensure coordination of benefits and a solid understanding of third-party insurance and health plan coverage. Avoid using staff time to chase claims for health plans or other coverage that are maxed out, says Towne Patient.
Gather information. In the aftermath of accidents, patients will be in shock and confused, so they may not be able to locate and provide third-party coverage policy numbers and other information. To ensure a clean front-end process, provide patients with a form or brochure that explains the information they will need to provide. A website or online form, as well as a contact telephone number, provides patients with convenient ways to share the necessary third-party coverage information to process claims, says Friedberg.