Paragon Identifies All Relevant Subrogation Opportunities, Including Medical Malpractice, and Automatically Initiates Reimbursements

ST. LOUIS: Intellivo, a leader in healthcare subrogation and recovery intelligence, today announced the launch of Paragon to enable health plans to accurately identify and pursue more reimbursement opportunities for maximum financial recovery.

As the fastest and most thorough subrogation detection engine, Paragon identifies and automatically pursues all healthcare claims that are eligible for reimbursement in real time. Many of these opportunities would remain undiscovered, adding up to millions of dollars each year that could be reimbursed to health plans.

How Intellivo’s Recovery Intelligence Closes the Healthcare Payment Integrity Gap

Paragon offers a fundamentally different approach to subrogation in three ways. First, it is powered by Intellivo’s proprietary network of public and private data sources including alternative insurance policies, property and casualty databases, legal filings, and data from surplus lines and excess insurance adjusters.

Second, it is built using a model Intellivo calls Reverse Identification. Instead of searching for potential reimbursement opportunities within paid claims, Paragon proactively brings alternative liability signals to the health plan claims. This illuminates the paid claims eligible for reimbursement.

Third, Paragon automatically asserts liens on behalf of health plans once reimbursement eligibility is confirmed to preserve funds. Reverse identification eliminates reimbursement delays and the need to send subrogation questionnaires to health plan members. This results in faster identification of all subrogation opportunities.

“Paragon’s innovation lies in its extensive network of data partners and the ability to quickly generate signals of potential reimbursement opportunities," said Dhiraj Sankala, chief AI and technology officer, Intellivo. “By connecting disparate data points and turning them into actionable findings, Paragon enables health plans to uncover reimbursement opportunities that would otherwise remain invisible.”

Identifying Maximum Financial Recoveries Including Medical Malpractice

Paragon is designed to uncover the most challenging, complex, and often overlooked recovery opportunities that traditional subrogation programs miss.

One of the most significant examples is medical malpractice, which is often among a health plan's highest-cost claims, yet can be difficult to identify. Additionally, a single medical error may generate months or years of related treatment, resulting in numerous claims tied to the same underlying incident.

Paragon addresses this challenge by linking claims data, legal filings, attorney representation, and other recovery intelligence signals to identify medical malpractice and other complex recovery opportunities.

About Intellivo

As an industry market leader in subrogation, Intellivo empowers health plans and insurers to maximize financial outcomes by identifying and pursuing more reimbursement opportunities from alternative third-party liability (TPL) payers. Through innovative technology and unmatched access to a proprietary TPL data network, Intellivo accelerates the identification of reimbursement opportunities while completely eliminating the need to fill information gaps through ineffective and burdensome outreach to plan members. With a history of almost three decades of excellence, Intellivo proudly serves the country’s largest health insurers and health plans. For more information about Intellivo, please visit www.Intellivo.com.

Fonte: Business Wire