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  • Advances in the health technology industry, specifically with regard to prosthetic devices, continue to develop at a fast pace. Insurance carriers face rapidly advancing technology that can be difficult to stay current on. These rapid advances present their own challenges that become especially evident when a claimant loses a limb due to a workplace injury which then results in a workman’s comp claim. An insurance carrier must fulfill its obligation to indemnify the claimant. In the continually evolving field of durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), an insurance carrier’s adjusters may not be as familiar with pricing auto no-fault and  workers’ comp claims involving limb amputations and prosthetic devices in a way that indemnifies the claimant while minimizing the cost to the insurance carrier.

    The insurance carrier’s duty is to restore a claimant to his or her original state. In the case of an amputee, this indemnification is nearly impossible due to the lost limb or limbs. Insurance carriers can ensure they keep up with the prosthetic devices and the health technology industry by partnering with a Workers Comp Third Party Administrator such as Northwood. As a third party administrator of auto no-fault and workers comp claims, Northwood provides its expertise in the DMEPOS industry to ensure the claimant is restored to his or her original state as closely as possible while simultaneously drawing upon its expertise to reduce costs and increase efficiencies for the insurance carrier.

    In the case of double amputee Oscar Pistorius, prosthetic limbs were able to assist him in his quest to become a runner and compete in Olympic relay races against able-bodied individuals. The prosthetic limbs Pistorius used to qualify for the 2012 Olympics were fabricated out of carbon fiber and resembled the letter ‘J.’ According to the Scientific American, these prosthetic devices were so advanced that there were reports showing that Pistorius was able to use up to 25% less energy while running than his competitors, and he was said to have an unfair advantage due to the advanced technology of his prosthetic limbs. In this case Pistorius would not only have been indemnified, but he may have even gained an advantage over his competitors because of the cutting-edge prosthetic limbs.

    While these reports contained conflicting information on Pistorius’ perceived advantage, this example shows the incredible advances of health technology and brings to light continuing advances to the DMEPOS industry. Northwood is an industry expert and will bring this expertise to an insurance carrier’s auto no-fault or workers’ comp claims involving catastrophic injuries such as limb amputation. An insurance carrier’s adjusters are limited in their expertise and therefore will not know what elements should and should not be included in a provider’s bill for a prosthetic limb. The adjuster will also not know the proper codes or pricing for prosthetics, which will result in higher costs to the insurance carrier for the prosthesis. Northwood specializes in the DMEPOS field and understands the intricate details of prosthetic devices and is an industry-leading expert on advances in the health technology field. When an insurance carrier sustains an auto no-fault or workers’ comp claim involving limb amputation, Northwood is fully equipped to provide the expertise the claimant and the insurance carrier require. For a referral or a no-obligation quote, contact Northwood today.

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