HCSG is a technology company that specializes in business process reengineering and automation for healthcare organizations. We aren't just a paid claim recovery company, nor are we just a billing company. Since 2001, we've been developing innovative technology that makes all of those things work better.
One of the first applications we developed was our workers' compensation recovery system for insurance payers in New York State. Early on, we realized we could automate most of the steps necessary to recover workers' compensation payments. With this realization, we developed a recovery application, specifically for New York State, that automates nearly 90% of the identification and recovery function. The application proved so effective that we quickly became the State's largest submitter under its data matching program.
The success of our workers' compensation application led us to explore new areas in which we could apply technology to solve other health insurance recovery challenges. One of the most obvious is using our data matching system to identify subrogation opportunities. This system allows insurance companies or their recovery agents to identify recoverable claims—even if members do not respond to company generated questionnaires, and even if their responses are less than accurate.
Our data matching program was recently put to the test by one of the nation's largest insurance companies. They conducted a pilot project to review the data matching capabilities of the nation's largest recovery vendors, and HCSG was a part of that pilot. They wanted to know if there was a way to identify subrogation opportunities in cases where the member does not provide either sufficient or sufficiently accurate information to determine if a case is recoverable. After a competitive review and selection process, this major insurance company chose to proceed with HCSG because we identified a significantly larger number of subrogation cases far more accurately and far more quickly than any other vendor they considered.
We found what everyone else missed.
Today, HCSG staff is working diligently to develop new and innovative ways to use technology to improve both the efficiency and effectiveness of routine and repetitive business functions. Most recently, this includes the introduction of an automated overpayment identification system that quickly and efficiently identifies overpayments, including improper coding, up-coding, double billing, and coverage issues.
What routine business process can we help you automate?