The COVID-19 pandemic has not entirely receded, but it is critical to be aware of another epidemic in addition to it. In recent years, opioids have become a growing problem in the United States. Thousands of people overdose and even pass away from the use or abuse of various forms of opioids. One life lost is one too many, which is why Northwood has had policies in place to do its best to help curb opioid abuse among claimants of the insurance companies it partners with.
Northwood acts as a durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), pharmacy, and ancillary service provider for insurance companies administering automobile no-fault and workers’ compensation claims. As such, it handles every single case file for multiple insurance companies. This allows Northwood to proactively observe any trends or potential areas for opioid abuse.
Even though the dangers of opioids are clear, some claimants may still be prescribed an opioid by a physician for treatment of injuries related to their auto or workplace accident. Opioids can be beneficial in limited cases, which is why they are not something to be banned entirely. However, Northwood takes particular care with claims involving the use of prescription opioids.
One way Northwood does this is by putting its pre-authorization policy into practice with every auto no-fault and work comp claim. Pre-authorization allows Northwood to review the physician prescribed service for each and every claim before the claimant receives the service. In the case of a prescribed opioid, Northwood would be alerted to the use of opioids through pre-authorization.
Once Northwood has reviewed the prescription and determined it’s injury-related, the prescription can then be filled by the claimant. Northwood’s system will continue to monitor any refill requests by the claimant. If, for instance, a refill request is filed before the appropriate time period is up, this will create an alert within Northwood’s system that team members will review. The team members will look at the file to determine whether the refill request is warranted and appropriate for your claimant.
This process is done quickly and efficiently, so it does not cause delay or frustration for your claimants, especially when the refill request was determined to be legitimate. If the refill request is determined to be too early or if potential for opioid abuse is identified, Northwood will follow up with your adjusters and examiners to determine the next best steps to ensure your claimant is safe.
By putting pre-authorization and prescription monitoring in place, Northwood is helping insurance companies do their part in curbing the tragic opioid epidemic. For more information about ways that your insurance company can partner with Northwood to do its part in fighting the epidemic, please schedule a call with Rosanne Brugnoni at 586-755-3830 ext. 3771.Leave a reply →