Contracted Payers

Contracted Payors – In almost all instances our hospital clients do not want to outsource their contracted payors or the government billing *(except VA as noted in our VA section.).  However, when a contracted payor needs to coordinate benefits with MVA this is a different story.  In most instances the contracted payor wants to put a lien on the patient’s TPL benefits.  In the second instance they want to dispute all charges until such time as they have proof that PIP is exhausted and that no medical payments insurance exists.  GO-SB can handle this segment of the claims process to keep the claims from traveling back and forth between the hospital and GO-SB.  However, in some instances the hospital desires to handle all contracted payor claims.  When this occurs we contract with the hospital to only handle the PIP or WC side of the claim and thereafter we turn those claims back to the hospital for handling to conclusion.  This is another way GO-SB is designed to work with our hospital clients to make things happen in the best way possible.