Who we serve

Helping state Medicaid agencies steward public funds.

We find liable third parties so Medicaid stays the payer of last resort.

You care about your residents. So do we.

State Medicaid programs have a hard mandate: cover the people who have nowhere else to turn, and pay only what the program truly owes. BRSi reviews claims for third-party liability both before and after payment, so cost avoidance and recovery run on the same data and the same standard. Our TPL team has replaced longstanding incumbents in multiple states, with structured transitions that keep cost avoidance and recoveries moving from day one.

State capitol dome against a clear blue sky

Cost avoidance and recovery from liable parties.

Avoid costs before payment.

OHI Discovery, our insurance discovery platform, finds other coverage before Medicaid pays, drawing on direct data agreements that reach 99% of insured lives.

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Reclaim what’s been paid.

We handle go-behind billing, pay-and-chase, Medicare crossover, and MCO recoupment past 180 days, all tracked in ARMS PRO®.

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Recover from multiple liable parties.

We pursue recovery from a range of liable parties, including casualty, mass tort, and estate claims, and we run credit balance audits and provider recoupments.

Fit your program’s rules.

Reclamation windows, cost avoidance policies, and MMIS or other claims system requirements differ in every state. We configure our processes to fit your needs.

Work with a Medicaid managed care plan? See how we support MCOs ↓

Results that protect public funds.

$127M+
Returned to states

Returned to state Medicaid programs in two years.

98%
Claim accuracy

Accuracy on the claims we work for state Medicaid programs.

<2 weeks
Casualty response

Casualty subrogation response time on a statewide program, down from three to four months at transition.

~25%
Reclamation claims paid

Share of transmitted reclamation claims paid on a statewide program, in a claim population heavy with duplicates.

For managed care organizations

Supporting Medicaid managed care plans.

Because Medicaid managed care plans run on fixed capitation rates, every claim another payer owes comes straight out of your budget. The window to recover those dollars is narrow, and once a claim ages past it, those funds may no longer be yours to recover.

Pushing recoveries back onto providers isn’t a good answer either, since it strains the network your members rely on. BRSi helps your plan keep more of its funds.

Talk to our team about your plan →
  • Cost avoidance for your plan.We find other coverage before claims are paid, so the liable payer pays first.
  • Direct billing.For claims your plan has already paid, we bill liable payers directly, which keeps providers out of the middle.
  • Medical and pharmacy.We work both claim types, including recoupment on claims past 180 days.
  • Full visibility.Our reporting shows exactly what we found, billed, and recovered.

Technology built for Medicaid TPL.

BRSi builds and runs its own insurance repository and ARMS PRO® platform, so we can adapt quickly when reclamation windows, cost avoidance policies, or program rules change. Every improvement draws on what our TPL specialists learn across multiple state programs.

For state programs, that means finding more liable payers before Medicaid pays, with every transaction open to your audit.

  1. Lessons shared across programs.

    Improvements we make for one state program are applied to yours at no extra charge.

  2. Smart matching, human review.

    Automated data matching flags likely coverage, and our specialists verify it before it’s billed or reported to your program.

  3. Onshore and accountable.

    A dedicated, 100% U.S.-based TPL team handles your program, from transition through reporting.

Questions from state Medicaid programs.

Yes. Reclamation windows, cost avoidance policies, and MMIS or other claims system requirements differ in every state. We’ve worked with MMIS and other claims systems across multiple states and customize our processes to your program.

Yes. With read-only access to ARMS PRO®, your team can review any claim, payment, recovery note, or determination at any time. Our recovery methodology is documented, and our reporting shows every claim we touch.

Let’s make sure you’re the payer of last resort.

Tell us what you’re working on, and the right person on our team will follow up.