Disclaimer: This blog article was written by an AdvancedMD partner. The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of AdvancedMD.
Are you among the 97 percent of physicians practices without a strategy in place for recovering out of network revenue?
Insurance reimbursements for out of network claims are a major component of revenue, and these claims are being massively underpaid. Continuous underpayments by insurance carriers generate substantial accounts receivable—for many practices, this is untapped revenue that can significantly improve cash flow and overall profitability.
How much revenue is on the table? This is a question the team of leading medical, legal, healthcare insurance, and practice management experts at Allia Group are frequently asked. Allia Group purchases accounts receivable related to out of network claims, serving as the plaintiff and litigating against insurance carriers using a bundled case model to transform leverage from carriers to providers.
Using AdvancedMD’s reporting functionality, Allia Group has been able to significantly reduce the time it takes to commence litigation, and then settle out of network cases and pay providers additional revenue.
Allia Group’s settled cases against major carriers are extensive and have resulted in significant revenue to providers. For example, Allia Group recently recovered $6.4M from three years of historical out of network claims for an orthopedic group. These payments from Allia Group resulted in a 60.7 percent annual increase in out of network revenue. Additional payments are projected to be $568,000 for each prospective year.
The depth of reporting and ease of use of Advanced MD’s reporting platform allowed Allia Group to identify the relevant accounts receivable to pursue and reduced the time for revenue recovery. Allia Group’s claims analysts were able to generate critical reports in a fraction of the time it would take to use more antiquated billing software.
What’s Next?
If you’re ready to significantly improve revenue, Allia Group can create value from your out of network accounts receivable. Don’t have the time to generate the report yourself? Allia Group can run the AR report for you and streamline the recovery process. Reach out today to schedule a call and start increasing your cash flow.