One of the top ten hospital systems in the US compared the performance of two vendors whom they considered to handle their Zero Balance TPL accounts (“ZBA”).

To the incumbent vendor, an experienced law firm that was handling ZBA, the hospital system offered a cohort of their hospitals located in a higher financial demographic market with a higher likelihood of the patients carrying adequate Personal Injury Protection (PIP) insurance.

To TPL Claims, the system offered another cohort of hospitals located in a market with a much lower financial demographic with a lesser likelihood of carrying adequate PIP insurance or any insurance at all.

Within three months, TPL Claims Detective outperformed the incumbent vendor by discovering at least 200% more revenue than the competitor. TPL Claims then asked the client for permission to audit the competitor’s cohort of hospitals, which was granted. Due to the additional data sources and intelligent filtering, matching, and clinical algorithms, TPL Claims Detective™ discovered approximately $1.7 million in additional revenue that was missed by the incumbent.

As a result, the system gave the national contract for all ZBA TPL accounts to our organization. TPL Claims Detective™ was the only revenue cycle service to exceed the health system’s goal for TPL discovery and recovery.