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The Challenge

Property and casualty – Network-based

An auto medical services provider wanted to distinguish its network-based cost management program to sensitive auto insurance carriers by demonstrating:

• Minimal provider noise through the use of network contracts to reduce medical cost
• Effective dispute resolution processing

The Solution

Ïã¸ÛÁùºÏ²ÊÏÖ³¡¿ª½±Íø customized a process for the company to document success in resolving disputes:

• Custom reports to oversee its internal escalation process and compliance with turnaround time requirements
• Monitoring tool to gauge its staff’s compliance with internal processes and guidelines
• Proactive dispute resolution to alleviate carrier concerns, often more perception than reality

The Results

Ïã¸ÛÁùºÏ²ÊÏÖ³¡¿ª½±Íø’s program enables superior carrier retention:

• Dispute rate less than 1% of bills processed
• Consistent achievement of contractual turnaround time obligations