Healthcare Recoveries Controversy
Healthcare recoveries are a division of services by a company called Trover Solutions, Inc. They are based in Louisville, Kentucky. They are often partnered with your health insurance company to inquire about your medical services, especially about your claims that might be a result of accident or injury by another party.
The purpose of the recovery service is to help insurance company avoid paying incorrect claims, recover claim payment and do the auditing for them.
The customers’ reaction to the healthcare recoveries vary between themselves. Most of them find it intrusive and pointless. Some others distrust it and accuse it as their insurance company’s debt collectors.
The others support it, because they think if the recovery company can eliminate their health insurance company’s unnecessary expenses, then the company will have better reason in serving them and keeping the premium low.
The Ethical Position of Healthcare Recoveries
The arguments of people who dislike the healthcare recoveries are rooted in their distrust to the company. Although their website is well-organized and the customer representatives are both courteous and helpful, one cannot help suspect the company because their health insurance company never mentioned anything about the recovery company.
They also testified that the number they call introduced themselves as their health insurance company, but have none of the number reckoning system the health insurance company has. The recovery company also has little data about the customers, not even the customer’s insurance member number.
Ironically they mail a letter to the customer’s home address, while the insurance company only has the customer’s PO Box. Another suspicion arises because the entire question inquired are already asked and answered to the health insurance company when they proceed with the claim.
It is indeed questionable why the health insurance company who partnered with the healthcare recoveries never give them a proper introduction to the customers, via websites or otherwise. Their motivation is clearly to eliminate unnecessary and undeserving claims, and that’s quite a solid reason to be given to their customers.
Furthermore, why asked the customers the same questions all over again when the answers are already noted before? It’s true that given the situation, most customers would be suspicious despite the maybe well-intention.
Another thing that caused customers to believe this is either a scam or an unethical effort by the health insurance company to recover the money they paid to the customer was the time range between the claim and the healthcare recoveries inquiry. It was considered unethical that an insurance company would grant a claim only to re-claim it back at later date.
If they were serious about it, they should have done it before granting the claim. Besides, sometimes the person being who ended up being asked for money was not even the customer, but the customer’s friends or families who happen to own the house in which the accident happened.
The Continuing Controversy of Healthcare Recoveries
It is not easy to decide who is right or wrong in this case. It’s true that a health insurance company needs to keep their profit solid, and they should be able to investigate how valid a claim is. It just should just be done before granting a claim.
By the description of the recovery company, their mission is to find a third party to blame and take the responsibility for paying the claim and reimburse the insurance company. It is unethical in itself, because in almost every accident or injury, there will always be another party to put the blame on, whether they are really involved or just happen to own the place.
The company is believed to be legit, though, so unless a court is opened to challenge the company, then healthcare recoveries are still going to do its job.