Trover Solutions, Inc.

Healthcare Recoveries

Healthcare Subrogation

Trover Solutions provides healthcare subrogation services to a number of the nation’s largest health plans, representing recoveries on behalf of millions of lives through proven subrogation strategies and processes. A six-step process ensures thorough, professional data and file management throughout the entire recovery process.

  • Control Data: After receiving and processing the data file of paid claims, Trover Solutions analyzes files to identify claims with recovery potential. Troveris®, Trover Solutions’ proprietary technology, accommodates multiple claims systems, locations and configurations.
  • Identify Accidents: Next, a tailored data mining procedure is applied to quickly identify all potential accident-related claims. 4,000 ICD9 codes are searched to the tertiary level and Trover Solutions’ new pharmacy subrogation service triggers the system to search an additional 114,000 NDC codes for related claims.
  • Investigate: Troveris® tracks every identified accident, initiating an automatic investigation cycle when files reach pre-determined “paid dollar” protocols. The system then generates a process to connect members with the Customer Service Center at Trover Solutions, where details are verified over the phone.
  • Manage Files: Following investigation, files are assigned to an expert team of claims examiners and litigation specialists based upon client-specific criteria. Once assigned, recovery personnel actively manage the file to recovery utilizing Trover Solutions’ fully automated online, paperless environment which ensures no file is lost or overlooked.
  • Negotiation and Settlement Authority: Seasoned claims examiners, experts in insurance regulations and well-trained in negotiation skills and state and federal laws manage settlement negotiations. When necessary, Trover Solutions engages their dedicated legal team for counsel, research and litigation management.
  • Report and Remit Recoveries: Trover Solutions supplements on-site and headquarter visits by providing clients with comprehensive executive, financial and claims information reporting on the status and projected outcomes of each individual recovery program. Recovered funds can be posted and transferred by check or a variety of convenient electronic methods.
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