Automobile no-fault claim costs continue to be a growing source of concern and constant focus for insurers in the state of Michigan. Not only are adjusters in the no-fault claim administration field partially responsible for reducing overall costs, they also must be cognizant of the growing administrative burdens and decreased productivity stemming from no-fault claims and their inherent complications.
According to the Spend Matters Network, nearly four-fifths of the premiums collected by insurers are being spent on claim payouts as well as general claim administration. Automobile no-fault claims involving prescription drugs contain a multitude of procedures and guidelines that must be adhered to by adjusters assigned to these claims. In addition, there are individual variables requiring further review that may drive up expenses, such as the nature of claimant injuries and type of prescribed medical treatments. With a myriad of factors at play within each of these claims, no-fault adjusters may have a difficult time identifying and strategizing efficient ways to reduce claim cycle times and decrease claim costs.
Some insurers have begun employing procurement specialists and partnering with a Third Party Administrator (TPA) that specializes in Pharmacy Benefit Management (PBM) in an effort to work with adjusters to assist them in reducing those expenses. While strategic sourcing and procurement specialists have traditionally been employed primarily within an insurer’s administrative or management departments, a growing number of insurers are realizing the many benefits these specialists can potentially implement in claim departments.
Procurement specialists tasked with employing cost-saving procedures for automobile no-fault claims involving prescription drugs will be most effective when partnering with a TPA specializing in PBM for a variety of reasons. Cost and time saving efforts within these claims must be handled extremely ethically and in a manner that accomplishes these goals for the insurer while indemnifying claimants and ensuring their high satisfaction levels. A TPA specializing in PBM such as Northwood acts as an administrator for auto no-fault insurers and works alongside procurement specialists and claim adjusters to bring both cost and time savings to its clients.
For instance, Northwood processes all pharmacy claims electronically rather than utilizing paper methods, which drastically reduces the no-fault claim cycle time for claimants requiring pharmaceutical services. Northwood also applies this paperless process to its coordination of medical benefits (CMB) with other health insurance for insurers’ claimants. By contracting a trusted and credentialed network of pharmacy providers across the nation, Northwood has also been able to reduce rates for insurers and their claimants on prescription drugs and other pharmacy services related to no-fault claims. With this network in place, insurers who have partnered with Northwood have realized increases in both claimant and adjuster satisfaction along with increased productivity and reduced cycle times within no-fault claims. Furthermore, Northwood brings a significant increase in accuracy to automobile no-fault claim adjudication via its proven claim procedures. For more information on utilizing Northwood’s PBM services, please contact them today.
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