CMO Forges Expedited Payment Agreement Covering Claims Process Inefficiencies

Continuus Care Management Organization has forged an expedited payment agreement with Home Care Path to cover inefficiencies in the WPS claims process since the service was out sourced from Madison Wisconsin to El Paso Texas.

Since January 31, 2015 Home Care Path has not been reimbursed for a claim submitted to WPS El Paso Texas for the authorized personal supportive care being delivered to Continuus members.  Continuus manages nursing home level of care individuals who choose to live in the community.  This is a population that would experience an unacceptable level of risk for repetitive hospital inpatient stays in the absence of regular personal supportive care.

Home Care Path was waiting on 30 thousand dollars of unpaid claims.  Home Care Path does not have the monetary risk reserve to go 2 months without a single claim being paid.  Continuus Provider Services immediately noticed submitted claims were taking much longer than normal to pay out.  After a data review Continuus Provider Services could calculate the entire period of the recurring claims noting a schedule variation since January 31, 2015. 

Using a progressive strategy Continuus pays Home Care Path.  WPS Insurance Company now holds funds in a similar capacity owed directly to the Care Management Organization. 
Home Care Path now has the revenue required to continue to care for the members being managed by Continuus. 

The expedited payment agreement essentially spells out - Continuus pays the vendor for the WPS Insurance Companies debt.  Now WPS Insurance Company owes Continuus for the unpaid claims.   This is a familiar technique facilitated through initial contacting with the CMO outsourcing their billing process to a third party . 

The staff of Home Care Path would like to take this opportunity to thank the Continuus Provider Services Department for all there hard work.