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    A seemingly endless variety of factors contribute to increased claims administration costs. Whether your insurance company administers automobile no-fault claims or workers’ compensation claims, it is essential to always take a proactive approach to controlling the cost of claims. An important topic to address within your company concerns the matter of clarity, or lack thereof, in billing. Overall, achieving clarity and transparency in billing can improve the bottom line.  

    A major opportunity to achieve greater clarity in billing pertains to building a trusted network of providers. It is vital to both the bottom line and to claimant satisfaction to provide access to high-quality medical providers. This can be a very time-consuming avenue and can also be very difficult to achieve, so insurance companies will save both time and money by partnering with an experienced third-party administrator (TPA) that has already taken the initiative to build a credentialed network of providers. Furthermore, the network of providers should be expansive enough to serve claimants all over the United States and also provide discounted rates to both the insurance company and its claimants.  

    These providers that are in the TPA’s network and that agree to give the insurance company discounted rates should also offer access to prescription medicines at no out-of-pocket cost to claimants. Claimants who are given the opportunity to obtain their injury-related prescriptions without the need to pay up front or submit reimbursement requests to their insurance company tend to report much higher satisfaction levels with the claim and with the insurance company itself. Therefore, the elimination of out-of-pocket claimant costs contributes to increased clarity in billing that further impacts the bottom line.  

    Insurance companies can also look to the Healthcare Common Procedure Coding System (HCPCS) for an opportunity to achieve more clarity in billing. The HCPCS procedure codes are notoriously complex and inherently provide the potential for overpayments to providers. Additionally, some providers may use not otherwise classified (NOC) codes frequently in an attempt to request higher payments from the claimant’s insurance company. Access to an experienced TPA that has the knowledge and resources to review and bundle these codes together where appropriate can significantly increase clarity in billing and reduce costs to the insurance company.  

    At Northwood, we are committed to providing excellence to the insurance companies that partner with us. We offer a trusted provider network, discounted rates, the elimination of out-of-pocket claimant costs and our extensive experience with HCPCS procedure codes and bundling. 

    For a more customized look at the ways Northwood can help you achieve more clarity in billing and improve the bottom line, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 to schedule a meeting.    

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