MTL Analytics Applied to Uncompensated Care (UCC)

Our unique suite of mass tort litigation (MTL) analytics is designed to identify patient encounters within a health system’s uncompensated care written-off Accounts Receivables data that identify patients who may qualify for claimant status for one or more of the active and clinically centric MTLs. We identify and prioritize those recovery opportunities for our health system clients through a sophisticated set of MTL algorithms and  facilitate a five-year uncompensated care (UCC) lookback when applying our MTL analytics.

 

Private Lien Holdbacks

These MTLs often maintain private lien holdbacks that are typically valued at 25% to 35% of the average settlement value of each given MTL. These MTL private lien holdbacks are set aside specifically to respond to financial obligations related to the billed charges that sit behind the uncompensated care encounters associated with provide treatment of patients injured by a defective drug, medical device or consumer product.

Additionally, patients are able to exercise their rights to recover – rights that may have otherwise been forfeited due to lack of awareness of those rights. Further, there is no professional liability exposure to healthcare providers as MTL represents products liability settlements against the manufacturers (not providers).  Examples of these MTLs include Roundup, Bard Hernia mesh, and JUUL e-cigarettes.

 

MTL Outreach & Recovery

Once our analytics have identified those current or former patients that have a high probability of successfully enrolling into a given MTL they are eligible for outreach, and the provider determines which recoveries it wishes to pursue. Current data suggest that only ~3% of all eligible MTL claimants are aware their potential eligibility and successfully enroll in a mass tort. This is largely due to lack of individual awareness of qualification or understanding of their rights. Our program focuses on the remaining 97% through a targeted outreach campaign which advocates for patients to allow them to determine whether or not they want to exercise the rights that they have to enroll in the MTL.

If the patient successfully enrolls, they are eligible to receive a portion of the settlement value of the applicable MTL within which they are enrolling, and providers and health plans are able to exercise their recovery rights. The program is compliant with HIPAA and other laws and regulations. We are not a debt collection agency, no money is ever collected from any patients, and individuals are able to opt out of the program at any time.

Allēus Health Analytics manages the entire administration of the program; from MTL discovery analytics, patient outreach and education, to related lien filing and resolution.

 

Financial Implications

Our analytics are averaging approximately 9% of a health system’s total Patient Allowances and Discounts as being potentially eligible for MTL private lien perfection and ranks the recoveries by Estimated Recovery Value and time to recovery. This enables healthcare providers to make an informed decision on which opportunities to approve for recovery pursuit.

Patient allowances and discounts include contractual allowances and discounts on patients’ accounts, such as: provision for bad debts, contractual adjustments, charity discounts, teaching allowances, policy discounts, administrative adjustments, and other deductions from revenue.