Administering claims can be complicated, even for seasoned adjusters and examiners. It pays to reduce complications within your company’s workers’ compensation and automobile no-fault claims, both for the benefit of the adjusters and examiners as well as for the benefit of your claimants. Could a single provider accomplish this? Overall, your company will realize gains by helping reduce complications as much as possible.
This fact necessitates asking whether your insurance company should work with a single third-party administrator (TPA). Because of the multiple advantages of working with a single provider, the answer to this question is a simple ‘yes,’ especially when it comes to claims that involve both durable medical equipment, prosthetics/ orthotics and medical supplies (DMEPOS) as well as prescription medicines.
Claims involving both of these physician prescribed services can significantly increase the challenges faced by your adjusters and examiners which in turn can have a negative impact on your claimants’ experience. Working with a single TPA that acts as both a durable medical equipment benefits manager (DBM) and a pharmacy benefit manager (PBM) is a smart decision for your company overall.
A single provider that integrates medical and pharmacy benefits will help reduce the workload for your adjusters and examiners. For example, the TPA will be able to remove the tedious and time-consuming task of comparing pricing from the to-do lists of your claims staff.
Most TPAs will have a network of providers that have agreed to offer a reduced rate on physician prescribed services. Not only does this help ease administrative burdens for your company, it also helps hold down the cost of claims. This, of course, means an impact to your company’s bottom line.
Some TPAs even work with the providers in their network to eliminate out of pocket payments for claimants. Again, this becomes beneficial to your adjusters and examiners in terms of reducing administrative time they spend on claims. However, this detail also translates to fewer frustrations for your claimant. Over time, this adds up to mean increased satisfaction levels as well as higher retention rates.
Benefits abound when it comes to choosing to work with a single TPA on your workers’ comp and auto no-fault claims. This article touched on a small number of them, and your company could realize even more advantages by working with a single TPA.
Northwood is an industry leading TPA that works with insurance companies as a PBM and DBM. With more than twenty years of experience in the field, Northwood will help your company transition to a single TPA in order to help hold down the cost of claims, reduce administrative burdens and ensure high claimant satisfaction. Call Rosanne Brugnoni at 586-755-3830 ext. 3771 for a customized look at why you should work with Northwood as a single TPA.Leave a reply →