Invicta’s RCM Insurance Recovery Team Extends Client Capabilities
In today’s challenging Revenue Cycle Management environment, comprehensive insurance balance recovery is a growing challenge for providers across the nation. We asked Derek Shaw, President, and Summer Dobbs, Vice President of RCM, to tackle our questions on Insurance Recovery.
What do you see as the real differentiator for Invicta’s Insurance Recovery services?
Invicta’s Recovery team serves as an extension of our clients’ business office in a variety of ways. As such, we have numerous performance differentiators.
- We supplement a client’s existing billing staff with a team of versatile claim analysts.
- We maintain open lines of communication with the management team to ensure client satisfaction.
- We have decades of experience operating in the Recovery space and use that understanding to serve as RCM consultants when the need arises.
- We can and do create custom databases to track Out of State Medicaid Provider Numbers and web access.
- We create conduits from the billing system to each carrier, within our scope of work, to submit bills and receive EOBs for efficient claim processing.
- Last but not least, we utilize technology-based solutions wherever possible.
Are your Recovery Specialists cross-trained on multiple payers?
All Invicta Recovery Specialists are continuously cross-trained and introduced to new payers as part of their professional growth and ongoing training with Invicta. The constant reinvestment into our Team maximizes the flexibility and agility Recovery can have with client needs.
Does Invicta handle aging insurance balances for all payers?
Yes, our Recovery Team will work all balances regardless of age once the accounts are referred. Discuss your needs with one of the skilled members of our Sales Team, and we can clarify age and recoverability of accounts relative to your specific situation.
Does Invicta accept both professional and institutional claims for billing and AR follow-up?
Absolutely! Invicta is here to serve and support provider organizations as well as individual providers. Contact us directly if you are an individual provider or represent the physician recovery team within an organization, and we will be happy to discuss your project.
Are initial bills and rebills required to be submitted through the Invicta Clearinghouse, or can your team use the provider’s clearinghouse/billing software?
Our team has the flexibility and experience to utilize either our internal clearinghouse or the client’s clearinghouse for all billing needs. Whether it is the initial bill or a corrected claim, our team will utilize the systems requested by our clients within their workflows.
What is Invicta’s reach, from a regional and national perspective?
Our skilled Recovery Specialists work without boundaries across all 50 Medicaid states to assist on: Commercial payer balances for all payers; Comprehensive Medicare Recovery; Veterans Administration; Workers Compensation; Auto Liability; and Third-party Liability.
What are the Scope of Service options for Insurance Recovery Services?
Invicta assists clients through a variety of project scopes, including:
- Insurance Aging Projects
- Custom payer or all payer balances
- Denial Recovery
- Legacy System Balance Recovery for System Conversions
- System Conversion Supplemented Recovery
- Medicare Aging and Denials Recovery
- Auto/Third Party Recovery
- Veterans Administration Recovery
- In-state and Out-of-state Medicaid Recovery
- Client Provider Enrollment Services available for Out-of-State Medicaid
What do you consider the “recipe for success” in your Insurance Recovery Service line?
To be effective and agile in a complex Recovery environment and to assure accurate and rapid payment recovery, Invicta’s team deploys the latest in employee training and cutting-edge RCM technology to every project including:
- Payer-specific bill edits to ensure accurate initial submissions
- Comprehensive Medicare analytics and claim status updates with our custom access to CMS and HETS
- Recovery Specialist payer cross-training that maximizes the agility and breadth of knowledge of all Team members deployed to a project.
- Skilled clinicians and legal professionals available for every project to ensure denials are appealed accurately and overturned rapidly.
- Internal clearinghouse platform capabilities covering all major commercial and government payers for electronic submission.
- Robotic Process Automation (RPA) deployed throughout the Recovery process to ensure repetitive tasks are optimized and our Recovery Specialists concentrate on the complexities and details of each account.
- Business Intelligence tools are tied directly to our proprietary workflow management system to ensure KPIs and project analytics are tracked in real time and our team stays agile.