Administering claims can be complicated for adjusters and examiners alike. Multiple factors come into play that can create more complexities within claims, and this is especially true as we navigate the impacts of the COVID-19 pandemic. It is imperative that your insurance company is as efficient as possible when it comes to administering workers’ compensation and automobile no-fault claims. Using one solution for both medical and pharmacy benefits makes much sense as your company works with claims during and after the pandemic.
When claimants have injuries that necessitate the use of durable medical equipment, prosthetics/orthotics, and medical supplies (DMEPOS) as well as prescription medicines, insurance companies face additional challenges. Utilizing a third-party administrator (TPA), as your one solution, to act as a durable medical equipment benefits manager (DBM) as well as a pharmacy benefit manager (PBM) will benefit your insurance company and claims staff in a variety of different ways.
First, with a TPA as your one solution, to act as a DBM and PBM, will help reduce the administrative burden on your adjusters and examiners. As the TPA takes on workers’ compensation and auto no-fault claims administration, many time-consuming tasks will be removed from the adjusters’ and examiners’ daily to-do lists. The TPA will absorb tasks such as comparing the cost of prescription medications as well as DMEPOS with different providers. Your claims staff can rest assured that the TPA will work on your company’s behalf to ensure the lowest cost possible.
Second, partnering with one TPA on all of your company’s claims will help increase the satisfaction rates of your claimants. It is important to ensure that your claimants have the best possible experience throughout their claims journey, and a TPA with DBM and PBM capabilities will provide the most efficient, convenient experience possible for your claimants. When your claimants are satisfied and taken care of, they will be much more likely to be satisfied with your company. This in turn can have significant impacts on your bottom line over time.
Third, your company can realize additional benefits such as gaining access to provider networks. This is critical for offering high-quality care to your claimants yet also has a further impact on your company’s bottom line. A provider network will offer discounted rates on prescription medicines and DMEPOs, especially when your company works with a multi-line TPA such as Northwood.
Northwood is an experienced TPA that can partner with your insurance company as both PBM and DBM. This partnership will help hold down costs, increase examiner and adjuster efficiency and help increase your claimant satisfaction levels over time. Schedule a call with Rosanne Brugnoni at 586-755-3830 ext. 3771 for a personalized look at why it makes sense to partner with Northwood.Leave a reply →