Across Mississippi and the Southeast, CFOs and revenue cycle leaders consistently report the same concern: margins are razor-thin, denials are climbing, and every overlooked dollar matters. According to Kaufman Hall’s 2023 National Hospital Flash Report, hospital expenses remain more than 20% above pre-pandemic levels while margins hover near 1%. In this environment, overlooked revenue streams aren’t just missed opportunities, they can be the difference between red ink and breaking even.
One of the most common blind spots is third-party liability (TPL) claims, especially auto-accident cases. Hospitals usually have airtight systems for Medicare, Medicaid, and commercial payers. Liability claims, though? They’re messy. They slip between departments, and no one truly “owns” them. And that’s how viable claims slip away year after year.
The Financial Stakes
The financial impact of these missed opportunities is substantial. A single auto-accident admission often runs $30,000–$50,000 in billed charges, with severe trauma cases reaching well into the six figures. National data shows that the median cost of hospitalization after a motor vehicle crash exceeds $56,000, with complex trauma cases much higher (NCBI Study). Multiply that across the patient volume of a midsize hospital, and the uncollected revenue can easily reach millions annually.
For rural facilities, the gap is even more stark. The American Hospital Association reports that U.S. hospitals provided more than $42 billion in uncompensated care in 2020. In Mississippi and similar states, where many hospitals operate on margins below 1%, losing even a handful of high-dollar claims can mean postponing building upgrades, leaving staff vacancies unfilled, or cutting community programs.
Why Do These Dollars Slip Away?
Three structural issues are most common:
- No clear ownership. Liability claims fall in between billing, compliance, and sometimes legal. Without accountability, they languish until deadlines pass. At one community hospital, claims sat untouched for more than 90 days because no department considered them a priority.
- Low priority. Compared to Medicare or commercial payers, these claims can appear like one-offs. That perception keeps them at the bottom of the stack, even when the dollar amounts are higher.
- Weak pushback. Unlike commercial payers, liability insurers often face little escalation. Without consistent enforcement, delays and denials become routine.
- Attorney involvement. Many auto-accident patients retain attorneys, who may postpone cooperation on payment details until a settlement is finalized. Without an effective mechanism to compel timely resolution, hospitals are often left waiting while claims grow stale.
Practical Steps to Close the Gap
The good news? Hospitals don’t need to reinvent the wheel. A handful of focused strategies can unlock dollars that are currently slipping away.
- Prioritize identification at intake. Liability claims are won or lost at the front end. Training registrars to flag auto-accident cases prevents them from being routed like routine payer claims. Too often, patients are admitted under a generic payer category, and the liability angle is missed until it’s too late.
- Accelerate coverage checks. Too often, liability verification sits for weeks. By setting clear turnaround times, for example, requiring verification within seven business days, hospitals can prevent viable cases from aging out. Some facilities that tightened verification processes reduced aged accounts receivable by more than 30%. Faster verification also improves patient satisfaction by ensuring bills don’t linger unresolved.
- Implement escalation protocols. Commercial payers expect escalation when they deny a claim; liability carriers often do not. Hospitals that set internal “clocks” to trigger supervisor review or legal escalation after 30 days send a strong signal that stalling will not work. This kind of structure shortens resolution times and changes payer behavior.
- Track and report performance. What gets measured gets managed. Adding liability claims as a visible KPI for revenue cycle leaders, such as “percentage of liability claims resolved within 90 days” or “average dollars collected per liability claim”, keeps focus on the dollars at stake and demonstrates progress to the C-suite.
A Path Forward
Research shows that hospitals who reengineer their auto-accident claims process often see collections improve significantly — in some cases by double digits within months (HFMA Denials Resources; Aspirion Case Study).
For hospitals under continued financial strain, closing this overlooked gap isn’t just about recovering incremental revenue. The lessons learned here — early identification, quicker verification, escalation protocols, and performance tracking — can also be applied to Workers’ Comp and other complex claim types.
In today’s environment, where a single percentage point can mean survival, third-party liability recovery is not incremental. It is transformational.
Robert McFarland
Robert McFarland is the Founder and President of Titan Collections, a healthcare revenue recovery firm specializing in Third-Party Liability (TPL) and Workers’ Comp claims. He has partnered with hospitals to recover hundreds of millions in overlooked revenue, developing deep expertise in one of the most complex and often neglected areas of hospital finance.
A graduate of the University of Chicago Booth School of Business (MBA ’24), Robert leads Titan with a focus on proprietary intellectual property and structured recovery protocols that maximize collections while ensuring compliance. He collaborates closely with hospital CFOs, revenue cycle teams, and technology partners to design scalable solutions that improve cash flow and reduce uncompensated care.
With a background spanning both entrepreneurship and healthcare strategy, Robert is passionate about helping hospitals strengthen their financial position while maintaining focus on patient care. He frequently engages with hospital leaders across the Southeast to share best practices, reduce denials, and unlock overlooked revenue opportunities, positioning himself as a trusted voice in advancing sustainable hospital finance.
