Your health plan has asked The Rawlings Group to review paid medical claims information and determine if another party may be responsible for the resulting medical treatments. Your medical claims include certain treatment billing codes that are often related to an accident or injury. This may include events such as an accident involving a moving vehicle, a slip and fall, injury on the job, medical malpractice, or a defective product.
No. The provider listed in the letter you received could be someone other than your physician. For example, this person could be an emergency room physician or radiologist who cared for you during your Date of Treatment period listed on the letter.
Yes. Confirming that your treatment was not related to an accident is important information for your health plan to know.
Rawlings will continue to attempt to contact you as your health plan expects members to cooperate in resolving these questions. Depending upon the plan you have, your health plan may pend claims until these questions are resolved.
Your health plan has contracted with The Rawlings Group to review medical claims that they have already paid to identify situations where another party may be responsible to pay those claims. By contract, The Rawlings Group is authorized to perform this service for the health plan, and complies with all legal requirements (HIPAA) and your health plan´s requirements for handling your protected health information.
Please call the toll-free number listed on the questionnaire that was mailed to you. A representative dedicated to your insurance carrier will be available Monday through Friday between 8:00AM and 8:00PM EST.
The Rawlings Group is comprised of The Rawlings Company, Rawlings Financial Services, Rawlings & Associates, and The Rawlings Foundation. All entities, except the Foundation, exclusively serve the health insurance industry by providing cost containment programs.
The Rawlings Group was formed in 1977 to offer legal services to insurance providers. Recognizing the need for specialized recovery services, Rawlings began the first subrogation outsourcing program for the healthcare industry. We subsequently began other outsourcing programs specifically dedicated to medical claims recovery, mass tort litigation, and pharmaceutical claims recovery. Today, The Rawlings Group is the nation’s leading provider of data mining claims recovery services.
Our focus is healthcare. Rawlings reduces costs in the health insurance industry by partnering with health plans to identify members who have other sources of coverage that are responsible for paying all or part of their claim costs. We then help our clients recover those dollars from the responsible party.
We provide all of our services by treating others with respect, integrity and compassion. That’s what you can expect, and that we expect of ourselves, whether it’s in interacting with our clients, their members, our employees or our community.
TRC may collect personal information from your use of this Web site that can be used to identify you. Such information includes your name, home address, home telephone number, and medical or employment information. TRC will use or disclose information about you, on behalf of your health insurer, only in a very limited manner related to your health insurer's claims activity for treatment that you have received.
The TRC Web site is not intended to appeal to children and TRC does not collect or maintain information from its Web site from any individual if TRC actually knows that person is under age 13 (thirteen).
This policy is effective as of March 7, 2006. TRC may modify or change this policy from time to time. Any changes or modifications will be posted on this Web page.