Administering automobile no-fault and workers’ compensation claims inherently comes with a variety of complexities. From indemnifying claimants to comparing provider invoices, adjusters and examiners often balance a multitude of tasks within each of their claims. Partnering with a durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), pharmacy and ancillary service provider such as Northwood can help your company design support models that balance claimant experience and claim costs for an improved bottom line.
Northwood is an industry-leading provider with over 30 years of experience administering both auto no-fault and work comp claims for a variety of insurance companies. Over more than three decades, Northwood has developed processes and procedures carefully crafted to ensure better experiences for claimants while simultaneously holding down costs for insurance companies.
One example of this balance involves Northwood’s use of pre-authorization on every auto no-fault and work comp claim. The benefits of pre-authorization are multiple, starting with the fact that every physician prescribed service undergoes a pre-authorization review. This ensures that all physician prescribed services are appropriate for the claimant, which helps improve claimant outcomes. Furthermore, pre-authorization also involves an expert review of whether the physician prescribed service is injury related.
Northwood’s pre-authorization process is unique among DMEPOS, pharmacy and ancillary service providers. Many providers choose to use a formulary rather than pre-authorization, which can lead to unnecessary costs for your insurance company. A formulary is essentially a list of medications that are covered. When a claimant is prescribed a medication that is not injury related yet is listed on the formulary, the provider will likely approve the medication simply because it is included in the formulary list. Northwood’s pre-authorization process would flag the medication as non-injury related, eliminating excess cost to your company.
Northwood has also developed an extensive network of medical providers which works in combination with pre-authorization to hold down costs and increase claimant satisfaction with your company. When a claimant fills a physician prescribed service with a provider in the network, out-of-pocket payments are eliminated. Reimbursement paperwork is also eliminated, which removes a common frustration point for claimants and claims team members alike.
Beyond physician prescribed services, Northwood reviews other aspects of an insurance company’s claims adjudication process to uncover ways to hold down costs and deliver an excellent claimant experience. From leveraging technology to granting claimants, adjusters, and examiners access to a care line staffed with knowledgeable team members, Northwood puts its experience to work for its insurance company partners and their claimants.
For a more customized review of what it may look like to partner with Northwood to adjudicate your auto no-fault and work comp claims, please call Rosanne Brugnoni at 586-755-3830 ext. 3771 to schedule a meeting.
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