Guest guest Posted March 17, 2011 Report Share Posted March 17, 2011 Another option is to use a service like Medfin Manager. One of our ortho clinics that refers to us uses this company. You will negotiate with Medfin for a % of billed charges and they basically buy that LOP account from you. You get paid on a % of your charges within 30 days and Medfin waits for the settlement. The provider then gets paid within 30 days at a reduced rate, but it is about the same reimbursement as health insurance and you do not have to wait years to get paid and then still have to deal with requests for discounts. This particular clinic calls the attorney involved and tells them that they need to use Medfin or else pay each visit for the patient with a credit card at time of service. It seems to work well for them. Cheri Freeman, CMRS Healthcare Reimbursement Services, LLC Austin, TX > > > > > > Average is $200/visit. Bottom amount is $160/visit. Biggest barrier is > > getting > > > attorney to sign letter of protection. > > > > > > > > > > > > Sumesh > > > > > > > > > > > > > > > ________________________________ > > > From: Rick Gawenda <rick0905@> > > > To: ptmanager <mailto:ptmanager%40yahoogroups.com> <mailto:ptmanager%40yahoogroups.com> <mailto:ptmanager%40yahoogroups.com> > > > Sent: Wed, March 9, 2011 8:56:37 PM > > > Subject: Attorney Lien Cases > > > > > >  > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2011 Report Share Posted March 17, 2011 Another option is to use a service like Medfin Manager. One of our ortho clinics that refers to us uses this company. You will negotiate with Medfin for a % of billed charges and they basically buy that LOP account from you. You get paid on a % of your charges within 30 days and Medfin waits for the settlement. The provider then gets paid within 30 days at a reduced rate, but it is about the same reimbursement as health insurance and you do not have to wait years to get paid and then still have to deal with requests for discounts. This particular clinic calls the attorney involved and tells them that they need to use Medfin or else pay each visit for the patient with a credit card at time of service. It seems to work well for them. Cheri Freeman, CMRS Healthcare Reimbursement Services, LLC Austin, TX > > > > > > Average is $200/visit. Bottom amount is $160/visit. Biggest barrier is > > getting > > > attorney to sign letter of protection. > > > > > > > > > > > > Sumesh > > > > > > > > > > > > > > > ________________________________ > > > From: Rick Gawenda <rick0905@> > > > To: ptmanager <mailto:ptmanager%40yahoogroups.com> <mailto:ptmanager%40yahoogroups.com> <mailto:ptmanager%40yahoogroups.com> > > > Sent: Wed, March 9, 2011 8:56:37 PM > > > Subject: Attorney Lien Cases > > > > > >  > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2011 Report Share Posted March 17, 2011 Years ago we went through the insurance but then some companies demanded their money back saying it was an auto med-pay claim and that should have been used first. Only after the auto med-pay was exhausted should it have been billed to private insurer. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc Bay St. Louis and Diamondhead, Mississippi Attorney Lien Cases > > Â > For those of you who take attorney lien cases, what is your average > reimbursement per visit once the case settles? What is your bottom amount that > you try to achieve? What have been some of your barriers in settling a case with > attorneys? If you would prefer, you can email me directly at rick@... > > Thank you in advance. > > Rick Gawenda, PT > Director of Finance > Kinetix Advanced Physical Therapy > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2011 Report Share Posted March 17, 2011 Years ago we went through the insurance but then some companies demanded their money back saying it was an auto med-pay claim and that should have been used first. Only after the auto med-pay was exhausted should it have been billed to private insurer. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc Bay St. Louis and Diamondhead, Mississippi Attorney Lien Cases > > Â > For those of you who take attorney lien cases, what is your average > reimbursement per visit once the case settles? What is your bottom amount that > you try to achieve? What have been some of your barriers in settling a case with > attorneys? If you would prefer, you can email me directly at rick@... > > Thank you in advance. > > Rick Gawenda, PT > Director of Finance > Kinetix Advanced Physical Therapy > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2011 Report Share Posted March 17, 2011 Years ago we went through the insurance but then some companies demanded their money back saying it was an auto med-pay claim and that should have been used first. Only after the auto med-pay was exhausted should it have been billed to private insurer. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc Bay St. Louis and Diamondhead, Mississippi Attorney Lien Cases > > Â > For those of you who take attorney lien cases, what is your average > reimbursement per visit once the case settles? What is your bottom amount that > you try to achieve? What have been some of your barriers in settling a case with > attorneys? If you would prefer, you can email me directly at rick@... > > Thank you in advance. > > Rick Gawenda, PT > Director of Finance > Kinetix Advanced Physical Therapy > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2011 Report Share Posted March 17, 2011 Now that is an interesting concept. We have not run across this before. We have companies that want to buy our bad debt but never our LOP's. Interesting and thanks for sharing. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc. Bay St. Louis and Diamondhead, Mississippi Attorney Lien Cases > > > > > > Â > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2011 Report Share Posted March 17, 2011 Now that is an interesting concept. We have not run across this before. We have companies that want to buy our bad debt but never our LOP's. Interesting and thanks for sharing. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc. Bay St. Louis and Diamondhead, Mississippi Attorney Lien Cases > > > > > > Â > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2011 Report Share Posted March 17, 2011 Now that is an interesting concept. We have not run across this before. We have companies that want to buy our bad debt but never our LOP's. Interesting and thanks for sharing. Matt Capo, PT Accelerated Physical Therapy and Occupational Health, Inc. Bay St. Louis and Diamondhead, Mississippi Attorney Lien Cases > > > > > > Â > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 18, 2011 Report Share Posted March 18, 2011 I am finding that more commercial health plans are adopting the " Pay & Pursue " policy. When we know that a patient was in an accident and wants to use their health ins. we do our usual verification of benefits but also ask " In the event this case is related to an auto accident, is this coverage expressly secondary to auto coverage, or do you pay and pursue? " . UHC recently adopted a policy of " pay and pursue " for claims that fall under a certain limit (I think it was $5k). We also have the patient sign an " Election Form " where they clearly choose to use either their PIP/Medpay or their Health insurance, or a combination of both with PIP being primary. In addition, this election form clearly states that they will be responsible for deductibles and copays at the time of service. They are not allowed to wait until there is a settlement to pay that portion. CHeri Freeman, CMRS Healthcare Reimbursement Services, LLC Austin, TX > > > > > > Average is $200/visit. Bottom amount is $160/visit. Biggest barrier is > > getting > > > attorney to sign letter of protection. > > > > > > > > > > > > Sumesh > > > > > > > > > > > > > > > ________________________________ > > > From: Rick Gawenda <rick0905@> > > > To: ptmanager <mailto:ptmanager%40yahoogroups.com>; <mailto:ptmanager%40yahoogroups.com>; > > > Sent: Wed, March 9, 2011 8:56:37 PM > > > Subject: Attorney Lien Cases > > > > > >  > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 18, 2011 Report Share Posted March 18, 2011 I am finding that more commercial health plans are adopting the " Pay & Pursue " policy. When we know that a patient was in an accident and wants to use their health ins. we do our usual verification of benefits but also ask " In the event this case is related to an auto accident, is this coverage expressly secondary to auto coverage, or do you pay and pursue? " . UHC recently adopted a policy of " pay and pursue " for claims that fall under a certain limit (I think it was $5k). We also have the patient sign an " Election Form " where they clearly choose to use either their PIP/Medpay or their Health insurance, or a combination of both with PIP being primary. In addition, this election form clearly states that they will be responsible for deductibles and copays at the time of service. They are not allowed to wait until there is a settlement to pay that portion. CHeri Freeman, CMRS Healthcare Reimbursement Services, LLC Austin, TX > > > > > > Average is $200/visit. Bottom amount is $160/visit. Biggest barrier is > > getting > > > attorney to sign letter of protection. > > > > > > > > > > > > Sumesh > > > > > > > > > > > > > > > ________________________________ > > > From: Rick Gawenda <rick0905@> > > > To: ptmanager <mailto:ptmanager%40yahoogroups.com>; <mailto:ptmanager%40yahoogroups.com>; > > > Sent: Wed, March 9, 2011 8:56:37 PM > > > Subject: Attorney Lien Cases > > > > > >  > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 18, 2011 Report Share Posted March 18, 2011 We have not really had any problem with getting the claims paid by health insurance with the exception of United. They would force patients who had medpay coverage to use their medpay money first and then they would pay if/once those funds were exhausted. With liability claims they would pay and pursue. They may have changed their policy. We are no longer contracted with them. We report on the billing form that the claim is the result of an accident and most insurance carriers send a notice to the patient asking for details. If necessary, they subrogate with the liability carrier. Have a great weekend!!! ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of mom4td Sent: Friday, March 18, 2011 10:45 AM To: PTManager Subject: Re: Attorney Lien Cases I am finding that more commercial health plans are adopting the " Pay & Pursue " policy. When we know that a patient was in an accident and wants to use their health ins. we do our usual verification of benefits but also ask " In the event this case is related to an auto accident, is this coverage expressly secondary to auto coverage, or do you pay and pursue? " . UHC recently adopted a policy of " pay and pursue " for claims that fall under a certain limit (I think it was $5k). We also have the patient sign an " Election Form " where they clearly choose to use either their PIP/Medpay or their Health insurance, or a combination of both with PIP being primary. In addition, this election form clearly states that they will be responsible for deductibles and copays at the time of service. They are not allowed to wait until there is a settlement to pay that portion. CHeri Freeman, CMRS Healthcare Reimbursement Services, LLC Austin, TX > > > > > > Average is $200/visit.Ã' Bottom amount is $160/visit.Ã' Biggest barrier is > > getting > > > attorney to sign letter of protection.Ã' > > > > > > > > > > > > Sumesh > > > > > > > > > > > > > > > ________________________________ > > > From: Rick Gawenda <rick0905@> > > > To: ptmanager <mailto:ptmanager%40yahoogroups.com> <mailto:ptmanager%40yahoogroups.com>; <mailto:ptmanager%40yahoogroups.com>; > > > Sent: Wed, March 9, 2011 8:56:37 PM > > > Subject: Attorney Lien Cases > > > > > > Ã' > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 18, 2011 Report Share Posted March 18, 2011 We have not really had any problem with getting the claims paid by health insurance with the exception of United. They would force patients who had medpay coverage to use their medpay money first and then they would pay if/once those funds were exhausted. With liability claims they would pay and pursue. They may have changed their policy. We are no longer contracted with them. We report on the billing form that the claim is the result of an accident and most insurance carriers send a notice to the patient asking for details. If necessary, they subrogate with the liability carrier. Have a great weekend!!! ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of mom4td Sent: Friday, March 18, 2011 10:45 AM To: PTManager Subject: Re: Attorney Lien Cases I am finding that more commercial health plans are adopting the " Pay & Pursue " policy. When we know that a patient was in an accident and wants to use their health ins. we do our usual verification of benefits but also ask " In the event this case is related to an auto accident, is this coverage expressly secondary to auto coverage, or do you pay and pursue? " . UHC recently adopted a policy of " pay and pursue " for claims that fall under a certain limit (I think it was $5k). We also have the patient sign an " Election Form " where they clearly choose to use either their PIP/Medpay or their Health insurance, or a combination of both with PIP being primary. In addition, this election form clearly states that they will be responsible for deductibles and copays at the time of service. They are not allowed to wait until there is a settlement to pay that portion. CHeri Freeman, CMRS Healthcare Reimbursement Services, LLC Austin, TX > > > > > > Average is $200/visit.Ã' Bottom amount is $160/visit.Ã' Biggest barrier is > > getting > > > attorney to sign letter of protection.Ã' > > > > > > > > > > > > Sumesh > > > > > > > > > > > > > > > ________________________________ > > > From: Rick Gawenda <rick0905@> > > > To: ptmanager <mailto:ptmanager%40yahoogroups.com> <mailto:ptmanager%40yahoogroups.com>; <mailto:ptmanager%40yahoogroups.com>; > > > Sent: Wed, March 9, 2011 8:56:37 PM > > > Subject: Attorney Lien Cases > > > > > > Ã' > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2011 Report Share Posted April 5, 2011 This is for everyone using the Letters of Protection. When do you have the patient's sign them? What about the patient who doesn't inform you that the case is legal until later? Subject: Re: Attorney Lien Cases To: PTManager Date: Friday, March 18, 2011, 3:45 PM  I am finding that more commercial health plans are adopting the " Pay & Pursue " policy. When we know that a patient was in an accident and wants to use their health ins. we do our usual verification of benefits but also ask " In the event this case is related to an auto accident, is this coverage expressly secondary to auto coverage, or do you pay and pursue? " . UHC recently adopted a policy of " pay and pursue " for claims that fall under a certain limit (I think it was $5k). We also have the patient sign an " Election Form " where they clearly choose to use either their PIP/Medpay or their Health insurance, or a combination of both with PIP being primary. In addition, this election form clearly states that they will be responsible for deductibles and copays at the time of service. They are not allowed to wait until there is a settlement to pay that portion. CHeri Freeman, CMRS Healthcare Reimbursement Services, LLC Austin, TX > > > > > > Average is $200/visit. Bottom amount is $160/visit. Biggest barrier is > > getting > > > attorney to sign letter of protection. > > > > > > > > > > > > Sumesh > > > > > > > > > > > > > > > ________________________________ > > > From: Rick Gawenda <rick0905@> > > > To: ptmanager <mailto:ptmanager%40yahoogroups.com>; <mailto:ptmanager%40yahoogroups.com>; > > > Sent: Wed, March 9, 2011 8:56:37 PM > > > Subject: Attorney Lien Cases > > > > > >  > > > For those of you who take attorney lien cases, what is your average > > > reimbursement per visit once the case settles? What is your bottom amount > > that > > > you try to achieve? What have been some of your barriers in settling a > > case with > > > attorneys? If you would prefer, you can email me directly at rick@ > > > > > > Thank you in advance. > > > > > > Rick Gawenda, PT > > > Director of Finance > > > Kinetix Advanced Physical Therapy > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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