Data compiled by the National Council on Compensation Insurance (NCCI) shows that medical benefit payouts have been rising. This can be hard for larger corporation’s risk managers, self-insured businesses and insurance companies like your own to deal with, especially since your goal is to keep as much money as possible in your employer’s hands.
NU Property Casualty 360 recently compiled a list of strategies that insurers, companies or guarantors can employ to manage workers’ compensation costs more effectively. You may find it helpful to employ some of these if you want to defend against insurance claims.
Why you should employ regular medical necessity reviews
It would be expensive if you performed a medical necessity review (MNR) on all claims. You could save significantly by doing so, though. You may discover that a worker’s work-related injury or illness resulted from a pre-existing condition instead of a workplace accident or injury.
The performance of an MNR may also reveal that some of the bills you received were for a worker’s injuries or illnesses unrelated to their work accident. This review may also shed light on the fact that the claimant deviated from their doctor’s prescribed treatment plan or received unnecessary procedures that added costs.
Establishing medical guidelines for treating patients
Insurers and self-insured employers can minimize costs by establishing guidelines that they require paneled doctors to follow when treating a patient. This minimizes the chance of unnecessary procedures that you get billed for.
How carefully selecting medical providers reduces costs
It can be in your best interest as an insurer to review how you select paneled doctors. You’ll want to ensure that anyone you add to your panel is well-versed in treating the conditions a claimant may present with. You’ll also want to learn more about the diagnostic tests they typically order and their cost. This insight will give you a better idea of what to expect in terms of how much a claimant bills you so you can remain on top of costs.
Your insurance company’s continued growth hinges on remaining compliant with all appropriate laws and regulations and being conscious of the money that comes in and out of the door. There’s always some fine-tuning that can be done to more effectively defend against claims.