DESIGNING A BETTER CLAIMANT EXPERIENCE

Efficiently and effectively administering claims is a top priority for insurance companies working with workers’ compensation and automobile no-fault claims. From holding down overall costs to sourcing the lowest pricing on physician prescribed services, administering these types of claims can quickly become complicated. Though your company’s job involves administering claims efficiently, it is crucial that you do not forget to design a better claimant experience.

Ensuring that your claimants have a good experience during their claims journey may not be the first thing that comes to mind when thinking about your company’s priorities. However, if you do not take care to improve the experience for your claimants, your company could experience some negative consequences.

For example, if your adjusters or examiners don’t reach out to your claimant soon after the claim is filed, that can be a source of frustration for claimants. This frustration is exacerbated if the claimant is unable to reach their assigned adjuster or examiner when they have questions or concerns about their claim.

Similarly, if your claimants are paying for their own physician prescribed services, that often results in a negative experience. Not only is the claimant paying out of pocket for a medication, but they will be required to submit documentation and a reimbursement request. This paperwork isn’t always intuitive, especially for claimants who haven’t filed a claim before. Furthermore, the reimbursement requests can be delayed as adjusters and examiners check into pricing and proper Healthcare Common Procedure Coding System (HCPCS) codes to ensure the best possible price.

If your insurance company were to take a more proactive approach in creating a better claimant experience, your company would reap multiple benefits. Partnering with a third-party administrator (TPA) for all work comp and auto no-fault claims is the first step in designing a better experience for all of your claimants.

An experienced TPA will help relieve some administrative tasks from adjusters and examiners, such as the task of searching for the lowest possible pricing on physician prescribed services. This may occur through the TPA granting your company access to a network of credentialed providers that agree to offer their services at a lower rate.

In some cases, the TPA will also have a pre-approval process in place for all physician-prescribed services. This is another time-saving measure, but it also means that your claimants won’t have to pay for their medications. Furthermore, they will avoid having to navigate the tricky process of requesting reimbursement.

Making the claimant experience smoother results in happier claimants who are satisfied with your company. Those satisfied claimants will be more likely to stay with your insurance company, resulting in higher retention rates.

For a customized look at how Northwood can help you design a better claimant experience, schedule a call with Rosanne Brugnoni at 586-755-3830 ext. 3771.