Synergy Blog

Ask A Lien Professional: Recovery Contractors

Question:

I have a case that has a private insurance lien. I sent in a notice to the insurer, but got a response from another company. What do I do with this? When resolving a possible lien with a private insurer, it is important to know who the involved parties are, and their role in the resolution of a case. You have received a response from a “Recovery Contractor” which is a separate company hired by the insurer to address all subrogation and recovery issues on their behalf. Recovery contractors have the authority to initiate collection activity against the insured, to provide information about the claims included in the lien, and act as the liaison between the lien holder and the insured in matters of lien negotiation. In order to get the best results from a recovery contractor, there are three things you should know.

1. They want to recover as much as possible – even if they aren’t entitled to it!

Recovery contractors are a lot like collection agencies. They want to recover as much as possible, because in some cases, it adds to their bottom line. The problem with that is, the amount that is submitted for payment is not always the amount that the claimant should have to pay. It is important to audit the claims included in the lien to be sure that they are all related to the compensable injury. Even more important is the evaluation of the plan language and plan type before making any offers or payments.

2. Sometimes they lie.

It is a bad thing, but it happens. Recovery contractors will sometimes stretch the truth in order to get the amount that they want. For example: If a plan is an insured employee health care plan with weak subrogation language, a recovery contractor may tell you that it is a self-funded ERISA plan with a stronger right of recovery, in hopes that an uninformed attorney or professional will pay the lien at face value. In many cases it works, and a payment is made out of ignorance that affects the net settlement to the client. It is imperative that the necessary research is done in order to avoid this pitfall. Request the Specific Plan Description to see what the plan is entitled to. Then request the Form 5500 to determine what type of plan it is, insured or self-funded. Once you have that information, you will be able to make a better decision before resolving the lien.

3. Get it in writing!

With all aspects of the lien resolution process, it is important to have a written verification of all offers from both your and the recovery agent. In some cases, there may be more than one associate handling the file. Having a “paper trail” is not only good practice, it may be helpful if there is a later descrepancy about the amount due in the case.

Synergy has developed resolution programs that address ERISA, FEHBA, Private Insurance, and Provider/Hospital liens. We have a proven record of success, let us help you get the best results on behalf of your client. For more information, contact Synergy at (877)907-LIEN (5436) and speak to one of our associates today!

TESTIMONIALS

"Synergy Lien Resolution Services was extremely knowledgeable and effective in assisting to reduce our client's insurance lien. They were a pleasure to work with, extremely professional, and went above and beyond the scope of our expectations. Many times, throughout our case, they worked after business hours to accommodate our needs. The end result was a huge savings for our client and we hope to utilize the Synergy again in the near future."

Joni Hautamaki
Didier Law Firm

"I recently engaged Synergy to assist with a complicated PTD settlement involving a substantial Medicare Set Aside. The claimant’s wife has been providing full time attendant care which is not Medicare covered. The Synergy nurse was able to do a full analysis of non-Medicare covered expenses which far exceeded the value of the MSA analysis performed by the carrier’s contracted MSA provider. The non- Medicare figures became the main focus of the settlement negotiations and more than doubled the value of the case. Although I could estimate the attendant care figures, the nurse added in other items that I would not have routinely considered. I also asked Synergy to evaluate the EC’s MSA as well as their prescription review. Synergy offered insight about the prescription donut hole which I did not have a clear understanding about. Again, their insight and information added a great deal of value to the overall settlement. Not only did I learn from Synergy but was able to educate my clients in the process. These are very complex and complicated areas; I will use Synergy again and again!"

Rosemary Eure
Lancaster & Eure

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