TPL Program Features

Capable of accepting cases both manually and electronically from client sources, cases are investigated for viability and then routed to case adjusters/and or in-house attorneys for recovery processing.

Electronic Case Identification
Electronic prescreens of ICD-9, CPT, and E-codes can be programmed and customized to cull out probable cases from client claims data runs on a monthly or other predefined basis. Additionally, many clients have opted to provide MCA with limited, remote access to their systems allowing our investigators to do their own queries for additional related charges and outstanding claims—adding value to each recovered case without impact to our clients’ employee time or resources. Clients can also set up a remote terminal on their premises in order to log on and access their claims data directly through the MCA system. 

Manual Case Identification
MCA provides on-site client training and education to Utilization Review, Claims, and Risk personnel, as well as other departments involved in claims handling and case management to facilitate manual case ID. Regular service visits maximize case collection and client updating, and follow-up in-services are conducted as needed to train new personnel or employ new identification methods. Each client's specific identification methodology is created based on a review of current procedures and tailored to client operations and MCA standards.

In the transmission of all patient records, MCA always acts in full compliance with both HIPAA and the Fair Debt Collections Practices Act, so privacy is always maintained at every level of investigation.