Pin the tail on the other guy: an encounter with Healthcare Recoveries subrogation service

Often when a dependent or I have a claim we get a letter asking us to call Healthcare Recoveries who works on behalf of our insurer, Blue Cross Blue Shield of MA. I know what they want: they are trying to figure out if someone else is at fault for an injury, whether the claim should be for workers comp instead of medical and whether I have other insurance beyond Blue Cross that might pay some or all. I usually try to ignore these requests because I know the claims are legitimate as billed and I don’t want to deal with the hassle.

But today, after getting a second request letter with a lot of bold print I decided to go ahead and make the call, which I’ve recorded in its entirety for your listening pleasure.

I’m not sure how much Blue Cross pays for this service but my guess is they’re getting their money’s worth. The total length of my call was 3:40, which included 1:05 of an automated system telling me why they’re calling and getting my event number. Then there’s 30 seconds of hold time, which is quite acceptable. Then about 2 minutes of interaction with a live operator, Tim.

In this case Tim was professional and courteous. He took it in stride when I told him I was recording the call, and he moved through the questions efficiently. As you’ll hear, this claim appears to include a mis-coding, which is something Tim must encounter all the time. He handles that one pretty well, too.

After determining that we can’t easily blame someone else for this injury, Tim double checks to see if this could be work-related (not likely considering the demographics of the patient) and whether I have any other insurance. After that we’re done!

In the recording I redacted identifying information about the patient and me so you will hear a few gaps.

I’m slightly annoyed that this business exists, since it basically just redistributes costs around the system. But as a Blue Cross Blue Shield customer I guess I’m pleased overall because it is probably keeping my insurer’s medical costs down, which might limit my premium increases at some point if I’m lucky! The interaction is perfectly pleasant and there is no sense that the insurer is trying to put the squeeze on me.

July 30, 2010

4 thoughts on “Pin the tail on the other guy: an encounter with Healthcare Recoveries subrogation service”

  1. Don’t communicate with Healthcare Recoveries.This is not going to keep healthcare costs down. Subrogation is complicated. The end result is its up to the insurance to prove it. If you don’t communicate with them they don’t have the information to proceed with anything. Most of the time they have no right to demand you to answer questions. The most common healthcare scams are Phantom Treatments, Double Billing, Shoddy Care, Unneeded Care, Identity Theft, Rolling Labs and Runners. Subrogation isin’t on most heathcare scam lists. If everyone Healthcare Recoveries contacted, didn’t respond, then it wouldn’t be cost effective. Help your fellow citizen and don’t respond, just to send a message to persue the real reasons why healthcare is so high.

  2. David, subrogation is a component of cost shifting and is not a scam. Many health care contracts contain a subrogation clause where the health insurer has either a contractual or statutory right to pursue other party liability. So telling your fellow citizen not to respond may be in violation of their contract with their insurer.

  3. Hello would you mind stating which blog platform you’re working with? I’m planning
    to start my own blog soon but I’m having a hard time choosing between BlogEngine/Wordpress/B2evolution and Drupal. The reason I ask is because your layout seems different then most blogs and I’m looking for something completely unique.
    P.S My apologies for getting off-topic but I had to ask!

  4. Sweet blog! I found it while surfing around on Yahoo
    News. Do you have any tips on how to get listed in Yahoo News?
    I’ve been trying for a while but I never seem to get there! Appreciate it

Leave a Reply

Your email address will not be published. Required fields are marked *