We assist large Michigan No-Fault PIP carriers to reduce their cost per claim while providing satisfaction to claimants and claim adjusters.
Headquartered in Madison Heights, Michigan, Northwood has over 25 years of experience working with Michigan No-Fault carriers, with an expertise in controlling claim cost and insurance premiums. Northwood’s program has definitive experience in specialty rehabilitation equipment and services auto claimants require for life.
With the steady increase of pharmacy costs, Northwood offers a specialized electronic Pharmacy Benefit Management Program (PBM) that provides significant savings on pharmacy expenses for carriers.
Northwood’s network is customized to process claims regardless of whether the claimant’s benefits are full coverage or coordination of medical benefits.
Michigan No-Fault Law – First party PIP benefits
Northwood has partnered with other No-Fault Insurance carriers and has the experience and resources available to assist claim adjusters with handling and processing claims for all home care products and services including durable medical equipment, medical supplies, orthotics, prosthetics, pharmacy, home health care services, home modifications, translation/interpretation and transportation services.
Northwood is geared to assist and serve the needs of claimants who sustained injuries such as soft tissue injuries, fractured bones and joints, other miscellaneous injuries and catastrophic injuries.
Adjuster Satisfaction
Improved PIP payment and facilitation process via:
- Elimination of contacting 2-3 vendors for service and pricing for durable medical equipment (DME), medical supplies, pharmacy, orthotic & prosthetic services (O&P) infusion services, home modifications, home health care services, translation/interpretation and transportation services.
- Elimination of seeking prescriptions for DME, medical supplies, pharmacy, O&P, infusion services, home modifications, translation/interpretation and transportation services and home health care services from physicians, hospital discharge planners, case managers, and other vendors.
- Elimination of reviewing the prescriptions to ensure requests for needs are appropriate.
- Elimination of telephone conversations with vendors to verify the appropriateness of services in regard to need, delivery dates and specifications for the equipment.
Letters of Medical Necessity
Elimination of seeking letters of medical necessity to determine whether the prescribed medications are medically related to the injury sustained in the accident.
Billing Process
- Elimination of “shopping around” for comparable pricing and cost savings
- Northwood obtains the Explanation of Benefits
- Timely payment to meet Section 3142
- No balance billing since providers commit to a fee schedule for pricing
- No upfront money expended by claimants
- Increases time management to be applied to other responsibilities in claim handling.
Insured Satisfaction
- One stop shopping
- Local and National Service
- No upfront money expended
- Elimination of tracking co-payment pharmacy receipts. No need to main to Insurance carrier to seek reimbursement
- Rush orders are given priority
- Equipment installation
- Training on the use of Durable medical equipment
- Maintenance on Durable medical equipment
- Direct bill to the primary medical insurance carrier
- Prescriptions secured from physician or other disciplines.
Vendor Satisfaction
- Strong working relationship with Northwood
- Northwood effectively communicates program policy and procedures to network providers.
- Customer service representatives are experienced, helpful and available to respond to questions about a plan’s coverage criteria.
Cost Management reporting
Customized reporting for each claimant receiving services. Detail reporting includes services provided, name of provider, amount charged, discounted savings and amount paid. Detail also includes provider’s name and address in order to calculate reimbursement for medical mileage.
Referral Process
Pre-authorization – eliminates a retrospective review
Who can refer to Northwood?
Physicians, adjusters, claimants, case managers, hospital discharge planners, attendant care providers, home health care agencies, and others.