Motor vehicle accident (MVA) claims represent a significant yet often underutilized revenue stream for hospitals. With the right approach, hospitals and healthcare providers can substantially increase their bottom line by optimizing the identification, processing, and collection of these complex claims.
The Importance of a Focused MVA Program
Many hospitals lack dedicated processes for handling MVA claims, leading to missed revenue opportunities. Common issues include failure to identify MVA cases at registration, inadequate staff training, billing errors, and missed deadlines. By implementing best practices, hospitals can see substantial increases in collections from these claims.
As Josh McVey, MVA General Manager at Aspirion, notes: “Having a good MVA program will positively impact your bottom line, and it is going to help you provide reimbursements on accounts that otherwise just may not get payment at all.”
Practical Steps and Strategies to Maximize MVA Revenue
1. Optimize the Registration Process
Registration is crucial for capturing essential MVA information. Key strategies include training staff on appropriate questions, using scripted questionnaires, educating patients on the billing process, and obtaining at least one piece of information to enable follow-up. “Registration is your best opportunity to get information,” says McVey.
2. Implement Timely Account Identification
While identifying MVA cases at registration is ideal, hospitals should also have secondary review processes. Running reports on diagnosis codes related to accidents can help catch missed MVA cases before timely filing deadlines pass.
3. Identify All Potential Payers
MVA claims often involve multiple potential payers. Hospitals should investigate all possible coverage sources, including:
- First-party medical payments or personal injury protection
- Health insurance (commercial and governmental)
- Third-party liability coverage
- Uninsured/underinsured motorist coverage
Aspirion attorney Martin Drake, Senior Director Complex Claims Legal, emphasizes the importance of thorough investigation: “Often the patients are confused about the process and they may not want to provide the information. So having resources who are well trained on these conversations and know what questions to ask is going be really important.”
4. Coordinate Coverage Appropriately
Once all payers are identified, hospitals must bill them in the proper order based on state regulations. Typically, first-party auto coverage is primary, followed by health insurance, then third-party liability; however, requirements can vary by state, so it’s essential to know the regulations of the state in question.
“Once you’ve identified the correct MVA payer, it is important to submit that bill quickly,” advises McVey. “Auto insurance usually pays bills in the order of receipt and there is a limited amount of money available to pay those first-party claims.”
5. Know Payer Preferences for Billing
Many auto insurers have specific preferences for claims submission. Understanding these preferences and submitting claims accordingly can speed up payment and reduce denials. Even if a patient says they lack coverage, billing the insurer to obtain an official denial can help extend timely filing on other payers.
6. Review Payments Carefully
Auto insurers often apply inappropriate discounts or underpay claims. Hospitals should challenge unsupported “usual and customary” reductions and verify that any applied discounts are contractually allowed. For states with fee schedules, ensure payments align with published rates.
7. Track Results
Implementing robust tracking and benchmarking is paramount for optimizing an MVA program. Key metrics to monitor include coverage identification rates, days to bill, payment success rates, yield of payment to total charges, and missed opportunities due to timely filing or exhausted benefits.
McVey stresses the importance of this step: “Look into what is working and what’s not working, and identify those missed opportunities. Once you’ve identified them, take the corrective actions you need and make your MVA program the best that it can be.”
The Impact of an Optimized MVA Program
By implementing these best practices, hospitals and healthcare systems can see significant improvements in their MVA collections. For example, proper registration techniques could turn a $312 self-pay discount into a $3,900 payment. Better follow-up could enable a $5,250 payment instead of a complete write-off. Secondary review processes could catch a $5,000 auto payment opportunity instead of settling for a lower Medicaid reimbursement.
For more helpful MVA tips, watch the first session of our on-demand webinar, “Cracking the Code on Motor Vehicle Accident Claims: Boosting Your Hospital’s Bottom Line,” or register here for our second live MVA webinar session on Sept. 11.
A Trusted Partner Can Be a Game Changer
While MVA claims can be complex, they represent a significant opportunity for providers to increase collections and improve their financial health. An experienced revenue cycle management partner that can shoulder the RCM burden and amplify revenue. In today’s challenging healthcare landscape, such partnerships aren’t just beneficial—they’re essential for sustained success.
Aspirion brings together the perfect blend of expertise and innovation to maximize your reimbursements. Our team of specialized attorneys, seasoned professionals, and cutting-edge technology work in harmony to outsmart even the most advanced payers. With Aspirion by your side, you’ll have the power to navigate the intricate MVA claims processes and recover every dollar you’re owed.
Eager to turn your MVA claims into a robust revenue stream? Contact us today!
