At first glance, pre-authorization may seem like more of a behind-the-scenes or background process that does not have a large impact on your claimants. But a closer look reveals that pre-authorization can, in fact, have quite a significant impact on your claimants.
When an insurance company administers automobile no-fault claims, that company has many responsibilities to its claimants. It is crucial to indemnify your claimants, yet it benefits your company to ensure that all of your claimants have the best experience possible. That can mean providing a customer care line staffed with individuals who understand claims and the insurance industry and are also easy to talk to. And if your company isn’t already implementing pre-authorization, now is the perfect time to begin so your claimants, as well as your company, can reap the many benefits.
As a pharmacy benefit manager (PBM) for a variety of insurance companies, Northwood is thoroughly acquainted with pre-authorization and how it can increase insurance companies’ claimant satisfaction scores. For instance, Northwood implements electronic adjudication with pharmacy providers in its network. Because pre-authorization is also a standard process with Northwood, these two combine to create a seamless experience for your claimant when filling prescriptions.
Once a prescription medication has been reviewed and approved by Northwood, your claimants will be able to choose a pharmacy provider. If they choose a provider within Northwood’s extensive network that spans the entire country, then your claimant will not need to pay for their prescription medication out of their own pocket. This is an enormous convenience to claimants, as some medications can be extremely expensive. Even with lower priced prescriptions, pre-authorization combined with electronic adjudication means a more simplified, more convenient claims experience for claimants.
Pre-authorization also means your claimants are well cared for and safe. That is because Northwood ensures each prescription medication is directly related to a claimant’s injuries before approving the prescription. This can help prevent accidental interactions with existing medicine the claimant may be taking. And it can even reduce your company’s cost of claims since it eliminates unnecessary provider invoices for non-injury-related prescriptions.
Furthermore, Northwood’s method of pre-authorizing all prescriptions includes pre-authorizing durable medical equipment, prosthetics, orthotics, and medical supplies (DMEPOS) as well. In addition, Northwood reviews provider invoices for DMEPOS to ensure providers are not practicing unbundling, which can drive up your cost of claims.
Ultimately, pre-authorization has a direct and indirect impact on your claimants. Indirectly, it can help your insurance company hold down costs, which you then may pass on to claimants if you choose. More directly, pre-authorization makes filling prescriptions much easier and much less frustrating for your claimants, improving their claims experience.
Northwood is an experienced durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), pharmacy and ancillary service provider that understands the importance of pre-authorization and its impact on your claimants. For more information on ways Northwood can benefit your company and your claimants, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771.
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