With a new year comes additional challenges for insurance companies administering both workers’ compensation and automobile no-fault claims. Continually rising costs for prescription medications as well as durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS) bring ever-present challenges and obstacles for insurance companies to work around. While there are several factors that figure into the increasing costs, the most important thing for insurance companies to focus on involves ways to mitigate the cost challenges within their control.
As an experienced third-party administrator (TPA) of auto no-fault and workers’ compensation claims, we at Northwood recognize these challenges and have compiled four ways that will assist insurance companies in addressing this problematic topic.
The first and most efficient way to combat the ever-rising costs in the industry is to partner with a TPA. Each claim administered by your insurance company will benefit from the thorough and objective review provided by the TPA. Innovative procedures developed through years of experience translate to savings for insurance companies.
Secondly, insurance companies will reap significant cost savings within claims administration by gaining access to discounted rates on DMEPOS services and prescription medications. Building a network of providers that agree to lower rates does take an enormous amount of time and effort. Fortunately, a TPA with its own network of trusted providers will offer access to this network to your insurance company as well as your claimants.
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A third method to battle rising costs involves implementing a pre-authorization process on each and every claim. The frequency of overpayments and payment of non-injury-related services will be greatly reduced by pre-authorizing every medication and treatment for each claimant. Claimants will still have access to the appropriate care they need yet insurance companies will avoid paying for treatments and medications that do not fall within the scope of the claim.
Finally, bundling of Healthcare Common Procedure Codes (HCPCS) during the pre-authorization process is essential to saving money for your insurance company. Many providers unbundle components of DMEPOS services in an attempt to receive a larger payment from the insurance company. Northwood’s process of rebundling procedure codes reduces costs for your company.
It is more important than ever for insurance companies to control costs. Partnering with a TPA, accessing a trusted provider network with discounted rates, implementing pre-authorization and bundling HCPCS codes are all essential to saving your company claims dollars. Northwood will bring its decades of experience to your company and save you time and frustration in the process. Please call Rosanne Brugnoni at 586-755-3830 ext. 3771 to discover additional solutions that are customized to your needs.
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