The subject of Michigan’s automobile no-fault coverage reform has been a prominent one in the last few months especially. Michigan’s auto no-fault coverage has been more unique and slightly more complex than many other states’ coverages. Prior to the proposed reform, the residents of Michigan could draw upon unlimited medical benefits if they were injured in an automobile accident. The reform is being modified but it essentially proposed that these medical benefits would be limited based on the benefit option secured by the policy holder. While there are many sides to this issue, Northwood can play an important role for your insurance company in holding down claims cost with the reformed auto no-fault coverage.
Your insurance company needs to stay informed on the various changes that could have occurred under the reform. While there are many crucial points to understand, one such change pertains to the fee schedule. Northwood’s fee schedule is significantly less than the proposed fee schedule which benefits the insurance companies that Northwood contracts with.
As an industry-leading third-party administrator (TPA) of auto no-fault claims, Northwood brings a variety of processes and procedures to its partners in the insurance industry that will help hold down claims costs. For instance, Northwood employs a utilization management (UM) review that brings with it a variety of cost-saving advantages.
A UM review will examine the claim to make certain that all physician prescribed services are injury related. This does two things: first, it helps to properly indemnify the claimant with provider services or prescription medicines that are necessary for the claimant’s recovery. Secondly, the assurance of injury relatedness translates to lower costs within your claims overall. With the assurance of injury relatedness courtesy of Northwood’s UM review, your company will only pay for the services necessary for the claimant’s recovery, virtually eliminating unnecessary payments for non-injury-related services.
Another advantageous benefit of Northwood’s UM review involves the proper usage of Healthcare Common Procedure Coding System (HCPCS). Many providers attempt to separate or unbundle HCPCS procedure codes for items such as wheelchairs in an effort to receive a higher payment from your company. Northwood employs their experience to identify instances of unbundling on provider invoices and then correct these procedure codes, bundling them together as appropriate. This practice is essential in holding down your claims costs.
Though the proposed changes of the new auto no-fault reform may be intricate and, at this point, modified, it is helpful to understand how they could impact your company. There are proactive ways that your company can ensure you hold down your claims costs as much as possible, whether or not the reform goes through at some point.Contracting with Northwood as your TPA will help ensure a better bottom line in a variety of ways. Ultimately, partnering with Northwood will help reduce unnecessary claims payments in several ways.