Resources: Case Studies
How MedSave USA, Inc. assisted a Medicare Advantage Plan
for their Record Retrieval Needs
June 8, 2011
SITUATION
With the Centers for Medicare and Medicaid Services (CMS) reporting deadline looming, a Northeast Medicare Advantage Plan with more than 50,000 members was running out of options. The Medicare Advantage plan needed to retrieve at least 15,000 medical records for their HCC Risk Adjustment Retrospective Project in order to validate the members' condition. The Medicare Advantage plan was looking for a Record Retrieval company to assist them to meet their fast approaching CMS submission deadline.
THE PROBLEM
With short notification, The MA Plan contracted with MedSave USA to conduct the collection project beginning early January 2011 to meet the CMS submission deadline of January 31st. The MA Plan set a goal of 15,000 charts, and after a brief review of the project, MedSave USA recommended dispatching MedSave USA on-site collection teams to the provider offices in order to get a faster turnaround and a higher % of charts retrieved.
The project included over 2,000 medical offices which were to be contacted and scheduled for on-site record retrieval considering the deadline, the time of the year, and the thousands of provider offices, it was extremely challenging to get all the required charts for the client.
SOLUTION
How utilizing MedSave USA's services can be a positive and cost-effective
experience:
MedSave USA's superior operations and information technology processes enabled the quick launch and implementation of all the unique requirements for this specific project. MedSave USA was able to complete the initial contact with all the providers within 5 business days and to start scanning records on-site within a week after receiving the suspect list. Within the first week of the project, MedSave USA scheduled over 80% of the required charts.
MedSave USA worked around provider office schedules and ramped up production for additional scan tech staff, dispatching multiple teams at multiple provider locations.
During the course of the project, MedSave USA's scanning technicians visited over 1,000 different provider offices and utilized the most advanced scanning equipment and EMR extractions tools.
By partnering with MedSave USA as the record retrieval company on this project, the Medicare Advantage Plan was able to meet the expected number of charts needed to submit their data to CMS by January 31st.
RESULTS
MedSave USA provided the Medicare Advantage Plan with outstanding service throughout the entire project, including scheduling, retrieval and quality assurance of every single image.
Service – MedSave USA as a committed partner met all milestones outlined by the client. Our experience and knowledge in the healthcare industry enabled us to render services to our client on a customized basis while ensuring to meet critical deadlines.
Volume – MedSave USA's automated procedures and IT platform enabled us to complete the high volume of required charts in the short timeframe. Due tothe high number of charts we were able to retrieve, the Medicare Advantage Plan was able to increase their revenue by over 20%.
Time – The workflow efficiency, interface between the systems, quality assurance and our experienced staff allowed us to complete the project under a very tight deadline. All the project milestones were met and the project ended before the CMS submission deadline of January 31st.
Positive Overall Return –MedSave USA prides itself on meeting client expectations in rendering our premier services. We work toward giving all our clients a successful experience through providing flexible, customized services, excellent customer care and state-of-the-art IT solutions.
Please visit www.medsaveusa.com or call us at (631) 780-5006 to find out how we can meet your record retrieval needs by saving you costs, time and resources.
Please visit www.medsaveusa.com or call us at (631) 780-5006 to find out how we can meet your record retrieval needs by saving you costs, time and resources.
How MedSave USA, Inc. Assisted Plaintiff Law firm in their Screening Process
May 8, 2011
SITUATION
A national pre-eminent law firm in the Northeast, representing plaintiffs in mass tort litigation related to a renowned pharmaceutical drug injury, was looking for a Record Retrieval Company to assist them with call center services and plaintiff case evaluation. The Plaintiff Law Firm was required to determine the validity of the claims as part of the intake and screening process; all services were to be performed in an extremely tight time frame and cost effective manner. MedSave USA, a leader in the record retrieval and litigation support industry, was chosen to partner with the firm in processing over 2,200 plaintiff fact sheets and in obtaining sets of medical and pharmacy records at the initiation of each case to assist in determining the merit, analysis and preparation of discovery.
THE PROBLEM
The case included thousands of potential plaintiffs and required the collection
of an overwhelming volume of medical records. The task of automating, monitoring
and tracking the record requests and the record status was almost impossible
and took too much time from the attorneys and their team. Additionally, most
of the medical providers required copy charges to be paid in advance, which
was overly burdensome for the firm's accounting department both in time and
resources; also, it would have required a much larger staff than they had
in place.
SOLUTION
How utilizing MedSave USA's services can be a positive and cost-effective
experience:
By partnering with MedSave USA as the record retrieval company in this
litigation, the Plaintiff law firm was able to continue accepting new potential
plaintiff calls, while focusing on its core business to gain additional clients
for the Firm.
We implemented procedures to support the Firm and resolve its main obstacles within a couple of days. As our Company is staffed with trained and experienced professionals, we enrolled and implemented the project specifications within a few days and were ready to go live with the unique project a week later. MedSave USA's customized IT record retrieval platform met all the Firm tracking and monitoring expectations, allowing seamless electronic interface between MedSave USA to the law firm branches. Our System (MStar ™) was used by the Firm as their Record Retrieval and Management system, which provided a hosting service to thousands of images obtained in this litigation. In addition, all the retrieved records were integrated into the law firm's case management system and a notification was sent out to all relevant contacts. MedSave USA's provider analyst team also contributed by identifying key pertinent providers from the plaintiff fact sheets so additional records could be collected to complete the Plaintiff's medical history.
The provider reimbursement process was taken care by MedSave USA's accounting department. We have established, during years of service, business relationships with most of the record custodian facilities in the country, resulting in faster turnaround time, reduction of record cost and monthly billing cycles (vs. per each case, which became an issue for the firm).
MedSave USA's customized IT record retrieval services were the solution to the P&C Insurance Carriers claims workflow challenges. MedSave USA established a seamless electronic interface with the insurance carrier's claims management system enabling them to receive the information and images of the records directly into the claims adjuster's queue and in real time.
RESULTS
MedSave USA provided the Law Firm with the utmost premier service throughout the intake process of this mass tort litigation.
Service – MedSave USA was a committed partner and met all milestones outlined by the Law Firm. Our experience and knowledge of the legal industry and court system enabled us to render services to our client and legal counsel on an as-needed basis while ensuring that we met critical deadlines.
Volume – MedSave USA's automated procedures enabled us to enroll and complete the mass production project in a short time. Due to these events, the law firm was able to drive 28% additional Plaintiffs through the system without increasing its personnel.
Time – Turnaround time was improved dramatically in comparison to other venues the Firm was investigating prior to engaging MedSave USA. The workflow efficiency, interface between the systems, quality assurance and our experienced staff allowed us to complete the project in a timely manner.
Positive Overall Return – MedSave USA prides itself on meeting client and legal counsel expectations in rendering our premier services. We work toward giving all our clients a successful experience through providing flexible, customized services, excellent customer care and state-of-the-art IT solutions.
How a Property and Casualty Insurance Company reduced Administrative Expenses and Improved Customer Service
May 2011
SITUATION
A large Property and Casualty (P&C) Insurance Carrier came to MedSave USA with the need to obtain of a high number of records to substantiate P&C claims submitted by their insureds. The P&C carrier retrieved records by utilizing internal staff and resources; over a period of time they found the record retrieval process time consuming and costly from both the financial and human resources perspective.
Due to limited staff and resources, the timeframe to collect medical records took much longer than their customers expected and, therefore, increased the number of phone calls to the P&C call center from the insured inquiring as to the claim status. These insured customers were tying up the phone lines and the P&C staff was spending more time on phone calls and performing more administrative work than necessary.
SOLUTION
How utilizing MedSave USA's services can be a positive and cost-reducing experience:
MedSave USA provided a customized record retrieval solution to the P&C Insurance Carrier by establishing a specific procedure to request records, setting up an automated process, and assigning users and workload with HIPAA compliant and secure access to our web based system on MedSave USA's website (www.medsaveusa.com)
MedSave USA's customized IT record retrieval services were the solution to the P&C Insurance Carriers claims workflow challenges. MedSave USA established a seamless electronic interface with the insurance carrier's claims management system enabling them to receive the information and images of the records directly into the claims adjuster's queue and in real time.
RESULTS
By outsourcing their record retrieval needs to MedSave USA, the P&C Insurance Carrier was able to obtain the records they needed within a shorter timeframe, thereby reducing administrative, professional personnel expenses, costs and company resources.
MedSave USA and our client have a long-standing partnership that continues to mature based on their increased record retrieval needs and MedSave USA's flexibility to accommodate them on an as needed basis.
Improved Customer Service – Within three (3) months of utilizing MedSave USA record retrieval services, the P&C Carrier reduced its pending claims inventory of non-litigated matters by over 25%; reduced the number of calls received from claimants and/or their representatives regarding claims status by 42%; and reduced the turnaround time of claims processing by 15%.
Positive Overall Return – The P&C Company reported a reduction in its overall expenses relating to claims processing, in general; and, more specifically, record acquisition. There was also a reduction in the direct cost per record collection as copy charges paid to the provider/facility decreased by 18%. The P&C Company also reported an increase in claims adjuster performance of >15%.
Please visit www.medsaveusa.com or call us at (631) 780-5004 to find out how we can meet your record retrieval needs by saving you costs, time and resources.
How an Insurance Defense Firm Supported their Client's Defense and Won a Verdict
April 2011
SITUATION
An insurance defense law firm retained MedSave USA, Inc. to collect medical and billing records, in support of their defense, for one of their insurance litigation cases. The project required MedSave USA to collect approximately 30 medical and billing records of the Plaintiff in this insurance litigation case.
27 medical and billing records were retrieved by MedSave USA and 3 records remained outstanding. On Friday, March 4th, 2011, we were notified by defense counsel that the remaining three records were needed for a scheduled hearing on Monday, March 7th, 2011 - in just 2 days.
SOLUTION
How MedSave USA overcame all obstacles to provide exceptional customer service and results:
In order to meet this expedited deadline for the defense law firm of no later than Sunday evening and retrieve the 3 final records, our Account Manager worked with the Release of Information Department at the provider's office and with a Supervisor of the copying company, who had our request in line for processing.
Because of MedSave USA's well-established relationship with the Release of Information facility and record custodian service, MedSave USA was able to obtain the records on time and by Saturday night. The records were downloaded and placed on our Company's web portal for the defense firm to log on, view and download prior to their deadline of Sunday night. Our web-based portal is a secure HIPAA compliant web tool which allows client access 24/7. This allows for real-time data exchange---an exclusive MedSave USA feature for medical record retrieval.
RESULTS
Customer Service – Going above and beyond for our client, MedSave USA's Account Manager handled these expedited requests outside of business hours illustrating her and the Company's commitment and loyalty to our clients.
Our company is proud of its fully dedicated service and support team for its clients' needs. MedSave USA's employees are exceptionally skilled in the nuanced, multi-tiered process of record retrieval and provide the highest level of client service and support possible. Within every operational level, we take pride in our team and their ability to bring the utmost customer satisfaction to our clients.
Meeting the short deadline, MedSave USA's staff was able to go above and beyond in order to retrieve the records on behalf of our client. This case study illustrates the commitment and dedication that MedSave USA's staff has in ensuring that its clients' needs are meet with the utmost satisfaction, especially when it comes to Court deadlines.
Positive Overall Results – The law firm was able to use the information from the records we received for them over the weekend in support of their client's defense and won a verdict of approximately $400K.
MedSave USA prides itself on its high quality performance in meeting its clients' expectations, through providing excellent customer service. Our exceptional staff are highly skilled and knowledgeable in the healthcare, insurance and legal arenas. MedSave USA's clients, benefit from our results – an increased savings of administrative expenses, a reduction in turnaround time, and utilization of fewer resources.
Please visit www.medsaveusa.com or call us at (631) 780-5004 to find out how we can meet your record retrieval needs by saving you costs, time and resources.