To say that the last 12-18 months has been uncertain is quite an understatement. The arrival of COVID-19, and with it a global pandemic, caused much upheaval and disruption across numerous industries. As your insurance company continues to navigate the novel coronavirus and the changes associated with it, now is a critical time to ensure that your company’s claims administration process is as efficient as possible.
Insurance companies administering workers’ compensation and automobile no-fault claims have myriad challenges, and managing costs associated with these types of claims is generally top of mind.
Many factors go into holding down costs, including choosing to work with a third-party administrator (TPA). If you’re currently working with a TPA, it is a good idea to review whether they are adding value to you and your claimants in these uncertain times.
There are several things to look for when it comes to assessing the value your TPA adds to your company. One example is whether or not they have spent the time to build up a trusted network of providers. An experienced TPA will have developed an expansive network of providers and will allow your company to access the network upon partnering together.
You will want to examine whether your TPA has a network that is convenient for your claimants. If your TPA has a large network that includes providers in each of the states where you administer claims, that can be an excellent value for your company. Not only will you gain access to discounted prices within this network, but your claimants will be more satisfied as well.
When a TPA has providers in its network throughout the United States, that allows your claimants many added conveniences. First and foremost, they will have more options to choose from for fulfilling their physician prescribed services. Claimants appreciate choices. Secondly, they will be assured of quality care if the TPA also regularly reviews these providers to be sure they are up to standards.
Third, your claimants should not have to pay out-of-pocket when they go to these providers. A TPA that adds value will have a pre-approval process in place that eliminates the need for claimants to pay for their physician prescribed services. Furthermore, this process also helps to ensure that claimants are receiving quality care that is directly related to their claim. The pre-approval process drastically cuts back on claimants receiving non-injury-related services or medicines, since the TPA proactively reviews all prescriptions before approving them for the claimants.
Working with a TPA that adds value helps your company manage costs and increases claimant satisfaction, which in turn impacts your bottom line. Schedule a call with Rosanne Brugnoni at 586-755-3830 ext. 3771 to find out how Northwood can add value for you and your claimants.