Healthcare
organizations are being squeezed on all sides, especially with
the high costs of controlling revenue. Working with the best-of-class,
Evergreen Re provides a suite of products and services especially
designed to help hospitals reduce administrative costs as well
as manage and reduce risks.
Disputed
Claim Management
Through
a unique program that automates, standardizes and recovers disputed
claims promptly and efficiently, Evergreen Re can help you improve
cash flow, reduce cost of managing disputed claims, improve
days in accounts receivables and decrease administrative time
and costs.
The disputed
claim management solution can:
- Handle
large volumes of denied and disputed claims without any additional
staffing
- Process
balance due accounts to all insurance plans in all states,
in all lines of business
- Handle
escalations of denied claims through the entire appeals cycle
- Generate
significant return on investment dollars, improving cash flow
and making better use of A/R staff
-
40-70 percent recovery rate for claims aged 45-120 days
- 20-25
percent recovery rate for claims 120 + days
- Empower
you're a/R department to exercise your appeal rights and take
control of the appeal process
- Reduce
the red tape and significant administrative costs associated
with filing disputed claims
- Provide
the most cost effective way to maximize your account receivables
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Hospital
Demand Forecasting
Working
with one of the country's leading actuarial firms, Evergreen
Re can provide hospital planners sophisticated tools to help
map out future utilization and needs in the community in which
it operates.
Using a
combination of market census and healthcare utilization rates,
the tool gives hospitals valuable information to guide the business
in the proper direction.
Demand Forecasting
projects:
- Future
demand for hospital services by defined geographic markets
- Utilization
forecasts that incorporate new technologies and treatments
- Quantification
of a hospital's current market share
- Forecasts
of market share based on proposed changes
- Revenue
impact caused by changing market share, by individual service
lines
- Capital
investment and strategic action required
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Managed
Care Provider Excess
Evergreen
Re can help your organization determine if you have the right
type and the appropriate level of provider excess loss coverage
at the lowest total net cost. As risk-bearing organizations
take on many of the responsibilities and risk from health plans,
our client services staff can help make sure you eliminate slow
payment of claims that threaten solvency and destroy cash flow.
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Transplant
Management Programs
The volume
of solid organ and bone marrow transplants has doubled in the
past ten years, and the number of people on waiting lists has
tripled. With advances in medical technology and immunosuppressant
drugs, the rate of transplants is expected to increase significantly.
According to the Centers for Disease Control, the increasing
incidence of Hepatitis C alone is expected to increase demand
for liver transplants by 500 % by 2008.
Managed
Transplant Insurance
A
comprehensive carve-out program converts this unpredictable
and catastrophic risk to a flat monthly cost, allowing payors
to budget for claims evenly throughout the year. Additionally,
cash-flow advantages may occur as reinsurance recoveries from
transplant claims are eliminated. This is typically a first
dollar coverage with no deductible, but we can tailor the program
to meet individual needs, specific procedures, limitations,
out-of-network benefits and specific hospitals.
Transplant
Programs & Networks
With an average
claim cost of more than $300,000, the increased frequency of
transplants can quickly become a catastrophic expense for most
organizations. We can provide an innovative transplant program
that can help reduce costs, increase productivity and reduce
access fees. Our programs provide access to nationally-recognized
centers of excellence.
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Hospitals
and Hospital Systems 
