Who is Managed Care Advisory Group, LLC (MCAG)?
MCAG is a service and consulting firm that was selected by the AMA and twenty-five (25) of the largest State Medical Societies to help physicians collect under the HMO MDL (MDL stands for Multi-District Litigation meaning it is a class action) Settlements. To date, MCAG has helped more than 90,000 physicians in more than 10,000 practices to submit and/or collect more than $200 million under the HMO Settlements. MCAG management has been recovering money from health insurance companies on behalf of both corporate plan sponsors (large, self-insured corporate plans) and physician practices for more than 20 years.
Why should a practice contract with MCAG?
Volume and Experience: MCAG is clearly the nation’s leading expert and most experienced service company when it comes to obtaining settlement payments for physicians. MCAG has submitted more than $120 million in claims on behalf of their client physicians and they have partnered with Allscripts/Misys, Athena, Gateway EDI, NDC Health, ClaimLogic, Cerner, and McKesson to get there. MCAG submitted more than 80% of the claims submitted under the CIGNA Settlement and has submitted about 25% of all claims submitted under the other settlements filed to date. Filing these settlement claims and audit/recovery of physician payments is MCAG’s primary business.
Relationship with Settlement Administrator/Insurance Companies: Nearly all of the Settlements have been coordinated and administered through a Settlement Administrator. MCAG has established a good working relationship with the Settlement Administrator, and that relationship has been beneficial in obtaining payments for physicians to date.
Rejection/Defection of Claims: Neither the Settlement Administrator, plaintiff’s counsel, defense counsel, nor any of the defendant insurance companies can be held liable for any mistakes made in the settlement process; and they do make mistakes. Thus, not only do physicians have to pay attention to the Notices, filing rules and deadlines for these settlements, they also have to expect to re-file their claims for both valid and invalid reasons when the Settlement Administrator rejects their claims for any reason. When a claim is rejected or defected, the physician practice may have as little as two weeks to re-file their claim after a notice of such defection or rejection. Essentially, since the Settlement Administrator has rightly or wrongly defected a very high percentage of claims submitted to them under previous Settlements, someone (hopefully MCAG) has to be an advocate for physicians in the process and assure that there is a timely follow-through on rejections and defections; otherwise there will be no payment to the physicians.
Automatic Collection/Effortless Returns: MCAG makes sure that clients do not miss deadlines or fail to collect on refunds that they are due under these Settlements. MCAG will maximize the return that the client is entitled to collect. Once the physician/practice enrolls with MCAG (one time only) MCAG will automatically file all returns/claims for physicians for the remainder of all settlements at they come due. MCAG files the claims, collects the money and returns the money to the practice after they extract their percentage fee. MCAG only collects a fee as a percentage of what they actually collect for the practice.
How do members sign up with MCAG?
The individual physician or practice signs a contract with MCAG (2 page contract) which outlines the fees to be charged, the services provided and it asks for some basic information about the practice (practice name, practice TIN, physicians names, physicians SS#, address, etc.). The practice faxes the contract back to MCAG who then contacts the practice and files the returns.
Contact: 1-800-355-0466