HFRI can recover over 50% of most denied third party claims. From issues related to managed care contract stipulations to clinical and medical necessity denials, HFRI has developed strategies for reversing these unfavorable decisions.
In recent years, Managed Care denials have become the single largest contributor to increased bad debts and reduced cash flow. Many hospitals are forced to pursue the patient for payment, resulting in write off and collection agency placement or simply adjusted due to contract language, which holds the patient harmless from responsibility for the account. Even if the patient is pursued, most collection agents are not capable of resolving many of these contractual or clinical issues that are key to reversing these denied claims. Therefore, the patient is pursued and often times results in reduced goodwill between the hospital and the public.
As an alternative, placement of these matters with HFRI can increase revenues and decrease bad debt while creating improved patient relations. Even if HFRI is unable to resolve the issue with the payer, the patient will know that the hospital exhausted every effort to reverse the denial. These services are most often less costly that standard collection agency fees, depending upon program utilization, and recoveries will almost always exceed those of other companies handling third party matters.
