Health Care Subrogation Administration

Exercising Your Right To Recover

The Subrogation practice area of OPL, P.C. provides health care subrogation administration, offering a depth of knowledge, a proven process, and comprehensive tracking and reporting services. Many of our clients have experienced an increase in recoveries since OPL began to service their subrogation program.

We have the capacity to perform the entire subrogation process beginning with Claim Identification based on claim tape (ICD-9) claim reviews through recovery. We are also willing to pursue difficult cases when the plan is unable to recover except through litigation. OPL accepts referrals from all Blue Cross plans and other insurers and TPAs for litigation on subrogation issues.

We are available to do a review of your subrogation department for claims efficiency and process improvement.

What Is Subrogation?

Subrogation is the substitution of one person in the place of another with respect to a lawful claim, demand or right against a third party, so that the substituted party succeeds to the rights, or "stands in the shoes" of the other.

Maximizing Health Care Recoveries

A major law firm administering subrogation claims in all 50 states, OPL, P.C. has the capabilities to efficiently pursue subrogation cases by:

using knowledgeable personal injury attorneys and staff to review and pursue referred cases;
administering the entire subrogation process from claim identification through litigation;
coordinating and maximizing your subrogation recovery efforts, and
supporting, enhancing or replacing many of the subrogation functions of your Other Party Liability Department.

Redifining the Subrogation Standard

We recognize that subrogation is but a small portion of the plan's overall administrative and customer service responsibility. Our focus is on both your satisfaction with our firm as a vendor and your customer's approval of our firm's interaction with subscribers. Insurers and administrators should be careful not to hire subrogation vendors whose short term financial goals may jeopardize your control over the subrogation process and the plan's long-term relationships with its customers. Our focus is ensuring the systematic pursuit and identification of all possible subrogation claims in a documented, effective revenue-producing manner. This will:

maximize the dollar value of your subrogation recoveries;
enhance your relationship with your customers;
show management and customers that you are diligently performing the administrative functions outlined in the benefit agreements, and
increase the amount of subrogation funds recovered.

Case Closed

Reporting and recoveries are done on a monthly basis, and closed cases are comprehensively documented. With our free software you will be able to produce reports not only to show how many cases you have investigated and closed, but why in each case, a recovery could or could not be secured. This information is very impressive to auditors and consultants who have generally criticized subrogation programs. By outsourcing your current investigative and administrative subrogation efforts to OPL attorneys, you gain:

maximized recoveries by using attorneys and their knowledgeable staffs;
increased group customer satisfaction and executive management financial concerns through greater recoveries;
improved tracking and reporting methods for both senior management and group customers, and
cost recovery from claim recovery rather than from your administrative budget.

Independent Investigation

To further assist with subrogation claim identification, OPL is currently initiating court house searches for subrogation claims in each of our clients' major markets. These additional claim identification services are done free of charge and are considered included as part of the contingent fees collected on cases in which we do recover.

Electronic Transfers

OPL offers a depth of knowledge, a proven process and comprehensive tracking and reporting services. Our attorneys approach subrogation cases by using knowledgeable staff who review and pursue all subrogation cases referred. OPL has the capacity to accept claim tapes or electronic transfers to generate its own questionnaire to your subscribers. OPL can also aggregate claims paid data, by subscriber, to eliminate the need for claim updates. OPL's proprietary Windows-based tracking system will allow you to identify and report your cases instantly.

Michael J. Laffey

Mr. Laffey is Special Counsel in the field of Health Care and Insurance Law. He has assisted in the collection activities of his clients' insurance companies, physicians and other health care providers for over 15 years.

Mike's practice focuses primarily on subrogation, assisting insurers and administrators to identify and pursue subrogation claims for clients who collectively insure or administer health care programs for over 10 million covered lives.

Mr. Laffey may be reached at 412-429-1769, 1-800-827-8276 or at mlaffey@subrogation.com. For current laws and our subrogation activities, please visit: www.subrogation.com.

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