Health Plans and TPA's still use accident questionnaires as the primary means to learn how certain medical claims came to their door. Whether generated internally by the claim payer or a subrogation vendor like us, these questionnaires are triggered by ICD-9 codes. Problem is, the ICD-9 code range indicating trauma or a “potential accident” is broad by definition. The result? Lots of questionnaires go out, many come back, all in the name of identifying subrogation recovery opportunities and satisfying stop loss requirements.
There's an easier way. Why not generate the questionnaires, but have them returned to us? We have claim paying clients who do exactly that. Their system automatically, and even in some cases, manually, generates accident questionnaires with return directions to us. We, in turn, review and advise whether to process claims or not or we follow up on any additional information needed. The advantages to this process are many, including:
An external review of the questionnaires also shifts the risk burden to the reviewer.
Contact us to learn more about this approach and how it can earn you more recovery revenue.