Business Impact
Physician Assessment of claim mitigation opportunities and direct written or verbal interaction with the treating provider, including but not limited to:
- Physician assessment of claim mitigation opportunities resulting in direct interaction with the treating provider
- Appropriate utilization of care
- Compensability or causality of treatment request
- Consultative and creative return to work suggestions
- Ideal pharmacy regimen (pain management, long term toxicology, narcotic intervention etc)
- Review of new and emerging medical techniques and pharmacy options
Bottom line Impact
- Lower claim costs (medical, indemnity and expense)
- Reduce cost of absence to the employer (all non-direct claim costs associated with absence)
- Support differentiated claim mitigation programs of our carrier and TPA partners
Our commitment
- Achieve 99% quality assurance audit score
- Maintain a 99% on time score for all transactions
- Direct provider contact rate over 65% (peer conversation)