COST-SAVING QUESTIONS MICHIGAN AUTOMOBILE NO-FAULT INSURANCE COMPANIES SHOULD ASK

COST-SAVING QUESTIONS MICHIGAN AUTOMOBILE NO-FAULT INSURANCE COMPANIES SHOULD ASK  IN EVALUATING THEIR  MEDICAL COST CONTAINMENT APPROACH FOR CLAIMANTS WHO WERE INVOLVED IN AN AUTOMOBILE ACCIDENT

The healthcare and insurance industries are becoming increasingly complex with intricate billing, claims and health benefit management systems. Insurance companies will greatly benefit from partnering with a third-party administrator (TPA) to assist with navigating the complexities of coordinating and managing benefits. However, in order to realize the greatest return on investment with a TPA, insurance companies must conduct research into each TPA being considered. It can be difficult to know where and how to start; the following are some cost-saving questions that a company needs to ask in order to maximize their savings with health benefit management solutions.

The first question an insurance company should ask is in regards to discounted pricing and whether the TPA has a network of pharmacy and home health care providers. As an experienced TPA, Northwood for instance has cultivated a very extensive network of durable medical equipment, prosthetic, orthotic, medical supply (DMEPOS), infusion, pharmacy and ancillary service providers that agree to discount their pricing for Northwood’s clients. In addition, each provider within this network undergoes a thorough credentialing process implemented by Northwood and renewed annually thereafter. This process ensures discounted pricing and a pre-determined fee schedule while also assuring that claimants receive quality medical services. Northwood not only controls costs for an auto insurance company in this way, but also controls the costs of deductibles and copays for the claimant due to the reduced pricing agreements in place with providers.

Secondly, insurance companies should ask if a TPA assures injury relatedness on all claims. The TPA must have staff that is familiar with home health care services and prescription drugs and the appropriateness of those services to each claim. Northwood employs highly trained personnel with years of experience working with home health care services and prescription drugs and ensuring they are  related to the  auto no-fault injury claim. When an auto insurance company refers to Northwood, they can be assured that Northwood’s customer service representatives are highly qualified to assist with these claims. Additionally, Northwood’s phone line is staffed 24 hours per day and seven days per week to ensure both insurance company and claimant satisfaction.

A third question insurance companies need to ask is whether the TPA coordinates injury-related pharmacy and home health care services with the claimant’s primary health plan. Northwood communicates directly with a claimant’s primary healthcare provider regarding copays on prescriptions and other home health care services. This communication channel ensures a higher degree of accuracy in the claims adjudication process and avoids duplication of efforts for all parties involved. Furthermore, claimants experience a higher level of satisfaction with the claims process and the burden of coordinating copays is removed from the adjusters’ workload, allowing them to focus on communicating with the claimant or their case manager.

Northwood has representatives available to answer additional questions with regard to health benefit management solutions and welcomes the opportunity to speak with your company on this topic.