Leaders in Medicare and Commercial COB
The Rawlings Group is the nation's leading provider of Medicare and commercial COB identification and recovery services for the healthcare industry; we recover more money for more health plans than any other vendor. This is an important fact, proving our staff, processes, and technology combine to provide our clients with the industry leading identifications and recoveries related to Medicare and commercial COB overpayments.
Identifying Hard-to-Find Overpayments
Certain overpayments are relatively easy to identify while others, those related to Medicare in particular, are far more difficult. The Rawlings Group uses a combination of innovative methods to identify a large number of hard-to-find overpayments, overpayments our competitors generally overlook. Since Medicare claims are often more costly, identifying these types of overpayments can result in significant recoveries for our health plan clients.
Improving Your Claims Payment Accuracy
Every time we confirm that a member has primary coverage through Medicare or another insurance carrier, we provide you with that information so you can update your internal systems and stop paying claims as primary. By avoiding claims you are not obligated to pay, you are able to substantially increase your savings.
Supplementing Internal Recovery Programs
Most health plans prefer to audit paid claims data internally before assigning them to a third party recovery organization for a secondary review. The Rawlings Group has extensive experience building these types of supplemental recovery programs to ensure that our efforts complement, not conflict with, your internal efforts.
Learn What Rawlings Can Do for You
We invite you to call our Business Development Team, at 877-426-4174. After answering your questions and learning more about your business, we can provide estimated financial projections so you can see for yourself the benefits of working with The Rawlings Group—the industry leader in medical claims recovery services.
Services
Subrogation & Workers' Compensation
Rawlings was the first company to offer subrogation outsourcing services to the healthcare industry. We have been providing those services on a national scope since 1985. Today, Rawlings is the leading subrogation and workers’ compensation recovery company in the nation. Further, our company pioneered most of the major innovations that are now industry standards.
Medicare and Commercial Coordination of Benefits
Rawlings provides comprehensive Medicare and Commercial COB (coordination of benefits) claims review and recovery services. We focus on the most complex and difficult to identify investigations. We combine our state of the art technology platform and legal and industry expertise to deliver outstanding financial results to our clients. In addition, the updated Medicare and commercial primacy information we provide allows our clients to pay claims properly and save millions of dollars through future cost avoidance.
Drug Claim Payment Integrity & Medicare Compliance
Since launching the industry’s first pharmacy COB recovery outsourcing program, Rawlings has refined the processes and systems necessary to perform well in this targeted segment. No other company offers the operational success that Rawlings has been able to achieve.
Mass Tort and Class Action Litigation
Rawlings introduced the health insurance industry to the concept of participating in mass tort claims to recover damages when a defective product, device, or drug causes damages and medical expenses to thousands of people. The first case was the multi-billion dollar claims in the silicon breast implant litigation. Today, we represent over 80% of the private health insurance market in such cases.