Claimant-Centric Care with Pharmacy Benefit Managers (PBMs)
Among many competing priorities within the automobile no-fault industry is the task of indemnifying claimants. And within that category, there are myriad subtasks your adjusters handle each day. There are a number of administrative items to be done for every auto no-fault claim, and each of them are important but can take up a significant amount of time for adjusters. Because of this, it can be easy for adjusters to unintentionally lose sight of keeping the claimant at the center of each claim. It is important that adjusters have the resources to be able to administer claims while also ensuring excellent claimant experiences.
Improve the claimant experience
Oftentimes, it can be immensely helpful for adjusters when their insurance company chooses to partner with a trusted pharmacy benefit manager (PBM) on each of their auto no-fault claims. A quality PBM will work with your company to proactively identify ways to improve your claimants’ experience from start to finish.
One example of this proactive approach is an evaluation of your company’s current process for claimant reimbursement on physician prescribed services. If your company is requiring your claimants to pay out of pocket for prescription medications and submit receipts and reimbursement forms, it is likely leading to an immense amount of frustration for your claimants.
Rather than requiring claimants to keep track of documents and send in timely reimbursement requests, it is important to consider working with a PBM who can eliminate these steps for your claimants. A PBM should have a large network of quality providers that offer discounted rates and high-quality care for its insurance company partners. This of course helps with cost containment for your insurance company, but it also ensures your claimants feel cared for.
Your company and your claimants would benefit even further if the PBM also has pre-authorization in place. With pre-authorization, the PBM will review every physician prescribed service before issuing an approval. This translates to vastly increased convenience for your claimants when they fill a prescription medication with one of the PBM’s providers.
First, this eliminates any out-of-pocket expenses for the claimant. That in turn means there is no record-keeping and there are no reimbursement forms for the claimant to fill out. They simply fill their prescription and take it home without having to worry about payment or losing a receipt, for example. Of course, this also relieves the burden on your adjusters, who will then be free to ensure they are keeping up with claimant needs and communications.
A PBM may also offer a customer care line, which ideally should be accessible to both claimants and adjusters. Adjusters can call in to quickly have questions answered or receive expert assistance with complex claims. Claimants are able to call the care line and speak with a person right away, which improves their experience and overall satisfaction with your company.
Increase claimant satisfaction
There are a multitude of benefits that come with putting the claimant first, and Northwood is a trusted PBM that provides real-time claim processing while keeping claimant experience top of mind. Please schedule a call with Rosanne Brugnoni at 586-755-3830 ext. 3771 to learn how you can improve your claimants’ experience.