Benefits of Pre-Authorization Versus a Formulary
Your adjusters administering automobile no-fault claims are tasked with handling multiple priorities within each claim. They work directly with claimants to indemnify them while also working on cost containment for your company when feasible. As an insurance company, it is important to streamline the claims adjudication process as much as possible. This benefits your adjusters and your claimants as well as your insurance company.
Streamline claims adjudication
Working with a proven, highly qualified durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), pharmacy and ancillary service provider brings in multiple benefits for your insurance company. More specifically, partnering with Northwood to administer all of your automobile no-fault claims brings immense benefits.
For example, Northwood has over three decades of experience administering auto no-fault claims. Over those decades, Northwood’s team has developed processes and procedures that streamline claims adjudication, improve claimant satisfaction, ease the time burden on your adjusters, boost retention rates, and more. Northwood is also able to integrate with any claims system, leveraging the use of technology to further streamline claims.
One important factor in working with Northwood involves its use of pre-authorization. Whenever a claimant is prescribed a medication, Northwood first reviews the prescription to ensure it is appropriate for the claimant and that it is directly related to their injuries sustained during their auto accident.
This approach is unique, as many other DMEPOS, pharmacy and ancillary service providers utilize a formulary instead of pre-authorization. Under a formulary, a provider will have a list of medications that are covered. When a claimant is prescribed a medication that is included in the formulary even though it is unrelated to his or her claim, the provider will likely approve the medication because it is on the approved list of medications. This drives up costs for the insurance company because it is now paying for non-injury-related prescription medication for its claimants.
Northwood instead reviews every physician prescribed service before approving it, assuring that the medication is injury related. The use of pre-authorization holds down costs as it eliminates unnecessary payments for non-injury-related medications. In addition, pre-authorization carries a number of other benefits, including increased convenience for claimants which leads to higher claimant satisfaction scores and improved retention rates over time.
Improve retention rates
Please schedule a call with Rosanne Brugnoni by calling 586-755-3830 ext. 3771 to learn more about the unique benefits of working with Northwood, including the advantages of using pre-authorization rather than a formulary.