As 2024 begins, it signals a key time to evaluate your insurance company’s bottom line. Examining ways to improve profitability is a smart move that will set your company up for success throughout the entire year. One of the most significant ways insurance companies administering automobile no-fault and workers’ compensation claims can improve their profitability is by working with an experienced durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), pharmacy and ancillary service provider.
Northwood, for instance, has more than 30 years of experience as a DMEPOS, pharmacy and ancillary service provider. This experience benefits Northwood’s insurance industry partners in a variety of ways.
First and foremost, Northwood embraces technological advances to the benefit of its partners. For example, Northwood has the ability to integrate with any claims system. This facilitates a seamless line of two-way communication between Northwood’s system and the claims system your adjusters and examiners are already using. This process reduces administrative burdens on your claims staff members since it eliminates the need to manually send or cross-check claims records.
When it comes to auto no-fault claims that involve prescription medications for your claimants, Northwood boosts profitability with its use of pre-authorization. Before any physician prescribed services are approved for claimants, Northwood reviews them to ensure injury relatedness. Prescription medications are also checked by Northwood’s experienced team members to ensure the medication is appropriate for your claimant.
Once this review is complete and the medication is determined to be injury related and appropriate for the claimant, Northwood approves the physician prescribed service. This is done without adding a delay to the claim, so it helps ensure a more efficient claims adjudication process. In turn, this boosts claimants’ satisfaction with your company which then increases claimant satisfaction rates and retention rates over time.
In addition, Northwood’s leverage of pre-authorization greatly reduces and even eliminates unnecessary costs to your insurance company. Other providers often use a formulary instead of pre-authorization, which can be thought of as a list of prescription and over the counter (OTC) medications that are developed from claims data. This list is largely based on claims payment history, so it does not guarantee injury relatedness like pre-authorization does.
Working with a provider who utilizes a formulary potentially means your insurance company will experience an increase in cost per claim. Your company may also issue overpayments and may need to request reimbursement from your claimants in some cases.
Northwood is a trusted partner for insurance companies in the work comp and auto no-fault industries. For a more in-depth review of the ways Northwood will work with your insurance company to improve profitability, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771.
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