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Third-Party Coverage Advocate

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Optimize reimbursement with streamlined accident claim resolution.

Our Third-Party Coverage Advocate service manages reimbursements from motor vehicle accident and workers; compensation claims. The service includes onsite professionals and back-office teams who handle patient interviews, documentation, investigations, billing, and claims management. Our team reduces confusion about claims and the billing process, decreasing or eliminating patients' out-of-pocket expenses while increasing your hospital's revenue.

  • Optimize Reimbursement

    By collecting accident claims, providers have the opportunity to transform complex claims into revenue. Our solution ensures proper payment and appeal through underpayment reviews and supports higher reimbursement on usual, customary, and reasonable (UCR) claims. Experience suggests that 30 to 40 percent of claims are paid at 100 percent of billed charges; individual results may vary.

  • Streamline Accident Claim Resolution

    Our hospital-based Patient Benefit Advocates manage the day-to-day workflows of medical claims and capture referrals early on. Onsite staff members interview eligible patients before discharge, ensuring proper documentation is filed. The offsite, back-office team manages the follow up, ensuring that claims are resolved.

  • Decrease Accounts Receivable Aging

    Because collecting is time consuming, manual, and costly, many complex claims may be unresolved for months or are written off as bad debt. Our service supports the resolution of complex claims, overcoming the challenges of state and federal regulations, legal situations, and health insurance complexities. We decrease the cycle time while initiating the process at the point of care.

  • Increase Patient Satisfaction

    Our Third-Party Coverage Advocate service reduces confusion about claims and the billing process, which lowers or eliminates patients’ out-of-pocket expenses while increasing hospital revenue. We serve as the single point of contact for patients involved in accidents, improving their overall satisfaction.