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  • NAVIGATING THE LANDSCAPE OF PROVIDER NETWORKS

    Choosing the best provider network can be challenging for insurance companies. This is especially true for insurance companies administering both automobile no-fault and workers’ compensation claims. While there are similarities between the claims, there are many differences and nuances present as well. Finding a partner organization with a provider network that can suitably handle both types of claims is critical for your insurance company as well as your claimants.

    To locate a network that best fits your company’s needs, you will want to consider several factors. First, it is critical to partner with an organization with a network that includes providers that are well-versed in auto no-fault and work comp claims. This can help improve overall claims efficiency.

    You will also want to assess how large the provider network is. If there are too few providers, this will make obtaining physician prescribed services a frustrating and complex process for your claimants. This can be detrimental as it will drive down your claimant satisfaction scores as well as your retention rates. Partnering with an organization that has built a sizable network is the best option. The network should include multiple providers in every state so your claimants can more conveniently locate a provider that is close to them.

    In addition, a provider network must offer contracted rates on prescription medication as well as durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS). These rates should be negotiated by the partner organization that created the network. This can have a direct impact on your overall cost of administering claims.

    Furthermore, a partner organization’s provider network must only include quality providers. The best way to determine if this is the case is to ask a potential partner organization what their criteria is for admitting providers into their network. At a minimum, each provider must be thoroughly evaluated for quality of care before being allowed into the network. Ideally, each provider will undergo additional evaluations about once every three-year period to ensure they are continuing to offer high quality care for claimants.

    Researching the various provider network options can be incredibly time-consuming, which is why it is smart to partner with an organization such as Northwood. As an experienced durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), pharmacy and ancillary service provider with more than 30 years of experience, Northwood has built up a vast network of credentialed providers. These providers offer high quality care for claimants, contracted rates, and are evaluated by Northwood before being admitted into the network. Northwood also prioritizes ongoing evaluations for all of its providers to be sure their level of care meets Northwood’s high standards.

    Partnering with Northwood will grant you and your claimants access to an expansive provider network. To learn more about how this can help hold down costs, increase claimant satisfaction, and more, please call Rosanne Brugnoni at 586-755-3830 ext. 3771.

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