HEALTHsuite®

 

Subrogation / Overpayment Recovery Module

 

HEALTHsuite's Subrogation / Overpayment Recovery module enables health plans and other health care payers to recover the cost of services provided to a member incurred as a result of the fault of another person, such as an auto accident.  This module features advanced functionality to support the coordination of subrogation investigations.

Among the features included in HEALTHsuite's Subrogation / Overpayment Recovery module are:

  • Automatic identification of claims that result from injury or accident;
  • Auto-generation of member questionnaires and follow-up actions;
  • User-defined processing to support both pay and pursue or deny and withhold;
  • Generation of subrogation case and auto-relating of initial and subsequent related claims;
  • Tracking progress of subrogation case through settlement or write-off including re-payment plans and litigation;
  • And more...

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