As the end of 2024 approaches, it signals a time to review what path your insurance company is on when it comes to managing the cost of automobile no-fault and workers’ compensation claims. If you haven’t done so already, now is an opportunity to evaluate ways your company can be more proactive in holding down costs overall.
Because it can be incredibly challenging to take an objective perspective, it may be most beneficial for your company to partner with an outside organization. Northwood is an experienced durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), pharmacy and ancillary service provider that acts as both a pharmacy benefits manager (PBM) and durable medical equipment benefits manager (DBM) for insurance companies administering auto no-fault and work comp claims.
Insurance companies that partner with Northwood realize a multitude of benefits, not least of which is more cost-effective management within auto no-fault and work comp claims administration. In part, those benefits are possible because Northwood takes a proactive approach on behalf of its partners.
For instance, pre-authorization is put in place for every claim administered by Northwood. This approach cuts back on unnecessary costs because it prevents insurance companies from paying provider invoices that include physician prescribed services that are not directly related to a claimant’s injuries. Over time, this can add up to significant cost reduction.
Northwood also reviews every provider invoice for accuracy. The Healthcare Common Procedure Coding System (HCPCS) is inherently complex because it contains thousands of healthcare codes for various procedures and services. It can be relatively easy for providers to inadvertently use an incorrect HCPCS code which could then unnecessarily and inaccurately drive up the cost of a claimant’s physician prescribed service.
On the other hand, some providers actively practice unbundling. This can take the form of billing for multiple portions of durable medical equipment (DME) individually rather than as a whole, which drives up the cost of claims. A common example of this is when a provider invoices for a wheelchair and adds additional codes for footrests, rather than choosing the bundled code. Northwood’s experienced team of caring professionals evaluates every provider invoice to eliminate this practice of unbundling, which further holds down the cost of claims administration for your insurance company.
Many additional options exist for insurance companies striving to hold down the cost of claims. Northwood has over three decades of experience with work comp and auto no-fault claims administration which translates to proven processes and procedures that assist insurance companies with more cost-effective management practices. If you are interested in taking a more in-depth look at specific ways your insurance company can benefit from a partnership with Northwood, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 to schedule a meeting.
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