Guide to Understanding SubrogationGuide To Moving From A Fully Insured To Self-Funded Health Plan
Offer flexible service options driven by client needs, innovative methods to identify more opportunities and master applicable laws, yielding results unmatched by anyone else.
The Phia Group identifies more opportunities to recoup funds and recovers more on a per case basis, consistently outperforming the competition. Thousands of organizations have decided to stop struggling with subrogation in-house, or have left their current subrogation service providers to join The Phia Group, subsequently enjoying incredible gains.
Subrogation & Third Party Reimbursements
The Phia Group’s clients enjoy attorney consultation, considered throughout the industry to be the most innovative leaders practicing today. Our team also reviews existing plans, with an eye towards improving each plan’s subrogation rights.
- The Phia System™ Enhances Recoveries through Advanced Case Detection Technology
- Opportunities Identified Through Multifaceted Investigation Techniques and Resources
- Cross Referencing with Litigation Databases and Social Media for Detailed Investigations
- An “Event” Based Approach Results in Less Noise for Plan Participants
- The Industry’s Most Certified Subrogation Recovery Professionals
Regardless of the cause, excess payments are pursued by overpayment recovery specialists. A team dedicated to recovering funds from providers understands the intricacies of the refund recoupment process, working towards unrivaled results.
Class Actions Recovery Services, Toxic Tort, Product Recalls, & Claim Recovery Services
Some opportunities are less obvious than others. Superior subrogation results are attributed to identification of more claim recovery opportunities and maximization of the funds recovered in each case. We always strive to produce ever improving results by innovating, and focusing on both our knowledge and technology. Keeping in-line with this philosophy, claims subrogation and recovery are now run through a second proprietary system to specifically identify instances where a participant utilized medication, products, or was exposed to toxic substances, that are now featured in some form of class action, recall, or litigation – presenting opportunities to recoup funds for the plan.
Litigation & Attorney Retention
There are times when even the most skilled claims recovery specialists cannot secure reimbursement. In those instances where litigation is absolutely necessary to recoup funds, options are presented and The Phia Group spearheads efforts to secure legal representation for their benefit plan client in the proper jurisdiction and venue. No cost is incurred without first obtaining plan approval, and The Phia Group accesses the nation’s most impressive network of subrogation litigators at the best possible rates.
Frequently Asked Questions About Subrogation and Recovery Services:
What kind of value can we expect from The Phia Group’s subrogation and recovery services?
The average case activation rate across the industry at large is one active case per 600 employee lives - but we at The Phia Group boast one active case per only 150 employee lives. In addition, our recoveries for established clients total an average of $30 recovered per employee per year, while the industry averages recoveries of $7 per employee per year.
What sort of reporting is included, and is there a cost associated with using it?
At no cost to the TPA or health plan, The Phia Group provides a comprehensive online reporting portal which is available online 24/7. Through this portal, clients can obtain monthly status reports, recovery reports, historical overview reports, and much more. These reports provide information with regard to active cases, closed cases, recovery numbers, and even day-to-day activity on individual cases, updated in real-time.
Can I access The Phia Group’s subrogation and recovery services on a case-by-case basis?
Yes. Although engaging The Phia Group’s full data-scrubbing subrogation and recovery service suite provides the greatest value to plans and their administrators, our services are available on a case-by-case basis when necessary.
How would switching to The Phia Group impact our member population?
The Phia Group aims to make the transition as seamless as possible. Customization of our processes as they relate to each particular client is encouraged, and we tailor our processes and correspondence to each client’s needs – even on a group-by-group or individual member basis if need be.
What happens if we identify a case that requires immediate attention?
After the Montanile decision, recovery cases cannot aord to be delayed. If you have one that requires immediate attention, please forward the case details to The Phia Group immediately, and our team of experienced case handlers and attorneys will behin to handle it without delay.