Proprosed Automobile No-Fault Reform & Claims Cost Savings

In recent months, a bill for automobile no-fault reform in the state of Michigan was introduced into the legislature. Key highlights of the proposed reform according to the Detroit Free Press included a call for reduced auto insurance premiums with a reduction ranging from 20 to 50 percent over a three-year period and a cap on medical fees for those using Medicare who were injured in an auto accident. The bill would have given seniors the option to use Medicare instead of auto insurance and would have introduced provisions that allowed the state of Michigan to oversee any premium increases within the following five-year period.  

The proposed reform would also have introduced personal injury protection limit options for insureds to choose from, including the current unlimited benefit as well as a $250,000 and $500,000 limit option. The state of Michigan is currently the only state that provides unlimited automobile no-fault benefits to claimants injured in an automobile accident. While these limitless benefits assist with the indemnification of injured claimants, they also pose a challenge in terms of overall claims costs.  

The proposed automobile no-fault reform bill was ultimately not ratified. Regardless of any legislative changes, however, adjusters should review their current claims administration processes for opportunities to reduce overall auto no-fault claims costs for their insurance company. To assist with this process, review the following three questions to ensure you are maximizing cost reducing efforts on all no-fault claims.  

First, is your insurance company working with a third-party administrator (TPA)? Partnering with a TPA on auto no-fault claims brings about cost reductions in a variety of ways. Experienced TPAs will have valuable knowledge and resources for adjusters to draw upon throughout the entire lifecycle of a no-fault claim. Additionally, the administrative burden on adjusters will be greatly reduced since a TPA will take over several aspects of claims administration, leaving the adjuster with the opportunity to maximize his or her time on each claim.  

Second, does your insurance company have pre-authorization processes in place? With every claim involving prescription drugs, your insurance company should be utilizing a pre-authorization procedure. Implementing this process will reduce claims costs by eliminating payouts on non-auto-related prescriptions for claimants. Furthermore, every prescription that a claimant fills that is auto-related will not require them to pay out of their own pocket. Claimants are shown to be more satisfied with the claims process when they do not have to pay directly for their auto-related prescription medicines.  

Finally, does your insurance company have discounted rates in place for claimant prescriptions and home health care products and services? An experienced TPA will have an expansive network of providers that have agreed to offer discounted rates to an insurance company and its claimants. Without this network and the pre-negotiated rates, your insurance company may be paying too much for prescribed services under its automobile no-fault claims.  

Insurance carriers contracting with Northwood as a TPA on automobile no-fault claims will realize reduced costs through a variety of ways. Please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 for a more customized look at ways you can reduce costs for your insurance company. 
https://www.northwoodinc.com/proprosed-automobile-no-fault-reform-claims-cost-savings/

Michigan’s Upcoming Workers’ Compensation Decreases & Claims Cost Savings

As 2017 draws to a close, workers’ compensation pure premium advisory rate changes for 2018 have been announced. For the coming year, Michigan’s work comp premiums will be reduced by 9.3 percent according to the Insurance Alliance of Michigan’s (IAM) November 10, 2017, update. This update illustrates that between 2011 through 2018, employers paying for work comp insurance in Michigan will have seen a total decrease of approximately 45 percent. This represents a claims cost savings of about $446 million over those seven years. In contrast, an average increase of 4.9 percent has been observed nationally and IAM reports that Michigan’s workers’ compensation premiums are among the lowest five in the United States.  

With the newly announced premium rate changes, it would be advantageous for insurance companies to take inventory of their current claims administration processes for workers’ compensation claims. A few key questions listed below will assist examiners in reviewing whether they are leveraging maximum cost savings techniques on workers’ compensation claims.  

The first question to ask in this cost review is whether the insurance company is partnering with a third-party administrator (TPA) of workers’ compensation claims since partnering with a trusted TPA will result in claims cost savings in a variety of ways. Experienced TPAs will provide valuable resources such as a call center with highly trained personnel that examiners may draw upon throughout the entire claims process. Furthermore, the administrative burden on examiners will be minimized since a TPA will handle multiple aspects of claims administration, allowing examiners to take on additional claims in their workload.  

Secondly, the offering of home health care products and services should be taken into consideration. Claimants experiencing injuries due to a workplace incident may recover more quickly if they are able to convalesce at home rather than in a hospital or a short-term rehabilitation facility. Insurance companies providing home health care products and services also tend to experience an increase in claimant satisfaction which further result in claims cost savings.  

The next question involves the use of a durable medical equipment benefits manager (DBM). As the nation’s leading DBM, Northwood has built an extensive network of medical providers throughout the nation. Each provider is subject to a thorough credentialing process before being accepted into the network and must agree to offer contracted durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) fees to insurance companies and their claimants. These discounted rates translate into claims cost savings for both the insurance company and its claimants. 

Since 1992, Northwood’s clients have saved over $200 million with a nearly three-to-one return on investment ratio. For customized, additional information about partnering with Northwood as a DBM to maximize workers’ compensation claims cost reductions please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 to schedule a call. 

Tips For Driving In Inclement Weather

The holidays are upon us. This means that we will be going over the river and through the woods to grandmother’s house. This time of year also means the chance for blustery skies, slick roads, and whiteout conditions. We’ll share with you how you can prepare yourself for driving in this winter season, and how to handle yourself when winter issues present themselves.

Prepare Yourself

One of the most important things you can do before you head out on the road is to prepare yourself and your car for the journey. How can you prepare yourself? You can begin by making sure that you’ve had plenty of sleep. You will need to remain alert on the roadways, not only looking for hazards but also remaining aware of the drivers around you. Another way you can prepare yourself is to have adequate clothing for the winter season. The best policy is to dress in layers so that items can be removed or added as needed to maintain the proper temperature. Keep a blanket in the car along with some snacks in case your vehicle gets stuck. Have a fully charged cell phone available as well.

Prepare Your Car

You can prepare your car by making sure that you have plenty of gas in the tank before you leave. One issue when the temperature drops is fuel line freeze up. By maintaining an adequate amount of gas in the tank, you can greatly reduce the possibility of your gas line freezing. The tank should never be left less than half full for an extended period. Additionally, make sure your tires are properly inflated, your fluids are topped off, and you have ice scrapers, and tire chains if needed. Be sure your headlights and signals are in working order.

While Driving

Remain aware of your surroundings and know the car that you are driving. Knowing your car means understanding how well the brakes work, how far in advance you need to begin breaking to adequately stop the car. Understand the drivechain for your car. Does it have a 4-wheel drive option?  Make sure that you have the correct weight distribution for your vehicle as well. This will affect your traction.

While you drive, be sure to maintain a proper distance between vehicles, if the winter season is very bad, then do not attempt to travel. When traveling uphill do not apply the gas heavily. This will cause your tires to spin, cause a loss of traction, and a possible slide down the road you are trying to climb.

By remaining aware of your surrounding and taking the time to properly prepare yourself and your car, the only memories you will have from your holidays are grandma’s fresh baked cookies.

Visit our website at https://www.northwoodinc.com/tips-driving-inclement-weather/

WORKPLACE WELLNESS

Workplace wellness is a growing topic of discussion in general but specifically within the field of workers’ compensation claims. The increasing advancement of mobile and wearable technology is a topic of particular importance to the workers’ compensation industry due to the benefits it can provide as organizations seek to increase wellness within the workplace. Insurance companies within the workers’ compensation claims sector must embrace new technologies and also must take a proactive approach in order to leverage the maximum cost savings and reduce the overall occurrence of claims.  

As technology advances and provides increased access to unlimited information at our fingertips through smartphones, computers, and tablets it represents a multitude of possibilities for improving workplace wellness and preventing some work-related injuries from ever occurring. Tom Ryan’s ideas written up in the Insurance Journal in February of 2017 provide some advantageous insights into new and innovative ways to implement wearable technology to reduce and perhaps even prevent some workplace accidents.  

The most effective way to introduce this new technology within the workplace, especially to those who are not typically early adopters of technology, is to provide an ultra-convenient method of integration. The popularity of wearable technology seems to be on the rise as one such convenient method. Watches, in particular, offer a lightweight and non-intrusive way to have technology always at the ready. A wearable watch is not likely to be forgotten or left at a desk and provides an inconspicuous way for an employer to ensure that employees are working at the correct location and at the appropriate times, which is especially vital to insurance companies offering home health care services to claimants.  

Wearable technology could be further utilized within the workplace to enhance safety and ultimately reduce the amount of employee injuries, therefore reducing the occurrence of workers’ compensation claims. Once these forms of innovative technology are embraced within a workplace, the potential to reduce incidents falling under the umbrella of workers’ compensation claims is significant. Those working in a highly dangerous work environment, such as construction sites or mining jobs, who wear safety equipment to alert them to dangerous situations that could cause injury will be better able to avoid injury altogether. This is beneficial not only to the employee but also to the employer and to that employer’s insurance company.  

In addition to the early adoption of preventative technology, insurance companies can further reduce the overall cost of workers’ compensation claims by partnering with a third-party administrator (TPA) of these claims. Northwood is a highly trusted and experienced TPA of workers’ compensation claims and works together with insurance companies to reduce costs, increase claimant satisfaction and reduce administrative burdens on estimators.  

For more information about how partnering with Northwood will reduce the cost of workers’ compensation claims for your company, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 at your convenience.  

Advances In Mobile Technology Reduce Claim Costs

With the rising costs of healthcare and increasing obligations of insurance carriers in the administration of workman’s comp claims, reducing costs and administrative burdens are increasingly becoming a top priority. Mobile health technology is an emerging field that has the potential to provide cost savings and reduced claim administration time to insurance carriers and their estimators for workman’s comp claims involving catastrophic injuries.

One of the most common workman’s comp injuries involves injury to the claimant caused by a slip or fall at work, according to Trusted Choice. When the injury is catastrophic in nature and the claimant sustains several broken bones or requires major surgery, it is often difficult if not medically prohibited for the claimant to travel alone to and from medical or other appointments related to the claim. It is in these types of cases that mobile technology can save insurance carriers money while reducing administrative burdens for the estimator assigned to the claim. For instance, telemedicine services offered by the workman’s comp healthcare provider would eliminate the need for that claimant to obtain assistance in getting to claim-related appointments. The claimant is much more likely to comply with the medical provider’s treatment recommendations which reduces the need for estimators to continually follow up with the claimant on treatment compliance. In turn, the claimant’s chances of requiring additional costly treatment or additional hospital stays are greatly reduced which also reduces claim costs for the insurance carrier.

Healthcare Information and Management Systems Society (HIMSS) conducted a study with 200 participants regarding costs associated with mobile technology in the healthcare field, or mHealth. The study revealed that the use of mHealth technologies assists in reducing cost while increasing quality of patient care received. Approximately 90% of the participants were already using mobile technology in their healthcare organization, which includes technology such as mobile apps for patients, telemedicine services and communication between patient and healthcare provider via text message. Just over 50% of the participants cited cost concern as a significant obstacle with regard to utilization of additional mobile healthcare technology for their organization; however, 54% of those surveyed stated a realization of reduced costs when mobile technology had been implemented within the organization.

The cost of implementing mobile healthcare technology within workman’s comp claims is but one of many challenges facing insurance carriers. When an insurance carrier partners with a Direct Medical Equipment Benefits Manager (DBM) such as Northwood, cost savings and reduced administration time on workman’s comp claims becomes a reality. Northwood has years of experience in the durable medical equipment, prosthetics and orthotics (DMEPOS) field and has built up an extensive network of contracted DMEPOS and pharmacy services providers. This network is accessible to workman’s comp estimators working for Northwood’s insurance carrier partners, and will save considerable time for the estimators on workman’s comp claims by allowing them to utilize its network of contracted providers. Please contact Northwood if your organization is interested in discussing this partnership.

Workers’ Compensation And Northwood

Technological advances are but one of many changes observed within the workers’ compensation industry. With the increased use of modern technology in workers’ compensation comes increased benefits to insurance companies and their claimants along with additional costs. Insurance companies administering workers’ compensation claims will realize significant cost savings and increased claimant satisfaction by choosing to partner with Northwood as their third-party administrator (TPA) of claims.

One avenue of workers’ compensation that is undergoing a bit of a revolution pertains to wearable technology that has the capability to monitor claimant improvements after an injury is sustained within the workplace. For example, an Insurance Journal article from February 22, 2017, highlighted the viewpoints of Tom Ryan from Marsh’s Workers Compensation Center of Excellence. Ryan touched on the benefits that can be realized once wearable technology is embraced in the workplace.

Technological devices that are easily wearable can potentially impact the workers’ compensation industry in multiple ways. Alerts would be received instantaneously by home health care workers when significant or alarming changes in the vital signs of workers’ compensation claimants occur. A wearable watch is an example of a device that could also function as a tracking piece to ensure the home health care worker is safe and attending to the correct claimants at the appropriate times. This small change would result in more efficient and effective service for claimants, which in turn would increase an insurance company’s overall claimant satisfaction rate.

Additionally, wearable technology can be adopted directly into a typically hazardous work environment to prevent injuries from ever occurring in the first place. Not only would this reduce the incidence and cost of workers’ compensation claims for an insurance company but it would also result in a general increase in workplace wellness.

While the implementation of new and emerging technology will provide myriad benefits to insurance companies in the workers’ compensation industry, there are additional things companies can do to more efficiently and effectively administer claims. One such way to reduce expenses and increase claimant satisfaction is to partner with an experienced TPA for all workers’ compensation claims.

Northwood is a seasoned organization that prioritizes the use of innovative systems and procedures to increase claimant satisfaction and reduce claims costs for the insurance companies it partners with. In addition, Northwood’s years of experience have culminated in a thoroughly credentialed network of medical providers that offer discounted rates to Northwood’s clients. Insurance companies utilizing Northwood as their TPA benefit from these discounted rates on durable medical equipment (DME) and are able to pass these savings on to their claimants.

Furthermore, claimants will not pay out of pocket for any injury related DME expense thanks to Northwood’s innovative pre-authorization process. Claimants will appreciate the extensive network of providers while an insurance company’s estimators will appreciate the reduced administrative burdens. Once Northwood becomes an insurance company’s chosen TPA for workers’ compensation claims, estimators can rely on Northwood for answers to some of the most common claimant questions and situations. Estimators will spend less time on the administrative portion of these claims because Northwood acts as a valuable resource and will be able to focus on more efficiently and effectively serving their claimants and administering additional claims.

Northwood is a highly trusted and experienced TPA of workers’ compensation claims and partners with insurance companies to reduce costs, increase claimant satisfaction and reduce administrative burdens on estimators. If you would like more detailed information on how Northwood can help you with your workers’ compensation claims, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 at your convenience.  

Check here for more information:https://www.northwoodinc.com/workers-compensation-northwood/

October is National Breast Cancer Awareness Month

October is Breast Cancer Awareness month. According to breastcancer.org, 1 out of every 8 women will develop invasive breast cancer over their lifetime. 1 in 8. A man’s lifetime risk of breast cancer is 1 in 1,000. The first recorded case of breast cancer was found in 1600 BC in ancient Egypt (www.maurerfoundation.org). With the advances in medicine and detection, cancers of the breast have the capacity to be found earlier, and there are more options for treatment. Here are some ways that you can keep an eye on your health. 

Family History 

Understand your family’s medical history. Is there a history of breast cancer, or any other cancer, within your family? If someone in your family had cancer, there is a greater chance that you could develop the disease. It is important to not only understand your family’s cancer background, but you must also know what stage they were in and what treatment was sought.  Ask your family if they know anyone in their lineage that had cancer, and ask if anyone had cancer more than once or in two different areas of the body.  

Self Exam 

There are people who will tell you that you need to examine your breasts once a month, and there are others who say this method is ineffectual. The important thing here is that sometimes your significant other can feel a change in your tissue before you do. This can pertain to men or women. If a change is felt, it is important to see your doctor to discuss the change that was found. There is no harm in examining your breasts once per month if you feel better doing this. There are shower cards that can be picked up to show you the proper technique.  

Mammogram 

If there is a history of breast cancer in your family or a strong cancer background, you will most likely need to start having regular mammograms at an earlier age than is recommended. You also might need to have a mammogram more than once per year. If you’ve had an abnormal mammogram, you might need to have them more often as well so that the doctor can keep an eye on the area of concern. 

Lifestyle 

Making sure you maintain the proper weight, remaining active and eating healthy are steps that you can take to reduce your cancer risk. You can help your family on the road to fitness by setting a good example. It is important to keep an eye on your family to notice changes and to check yourself regularly as well.  

Avoiding Prescription Errors Within No-Fault Claims

Automobile no-fault claims that pass across an adjuster’s desk contain a myriad of injuries and a wide variety of treatment options and recommendations. Not uncommon among many no-fault claims is the use of prescription drugs to treat injured claimants. The involvement of prescriptions necessitates that adjusters must work with not only the injured claimants but that they also work with pharmacy services providers in order to properly indemnify the claimants.  

An additional challenge with these types of claims is the fact that as many as 50 million of the four billion prescriptions filled each year in the United States may be inaccurate, according to NBC New York’s investigative study. While this number is staggering, it is more or less an educated estimate. Currently, there are no laws in place that require errors on prescription drugs to be disclosed. Together with the challenge of assuring auto-relatedness of prescriptions, these errors are a major concern for insurance carriers facing steadily rising costs of auto no-fault claims.  

Many insurance companies typically have some type of system in place that allows for a review of prescribed medicines for their no-fault claimants. However, there are oftentimes flaws or missing checks and balances within those systems that inadvertently lead to non-injury-related claimant prescriptions being approved and paid for by the insurance company. One common situation that occurs involves a claimant with a pre-existing condition or illness that requires them to use prescription drugs for treatment. Claimants are typically unfamiliar with the intricacies of claims processes and may unknowingly submit their auto-related prescription together with the non-auto-related prescription to the insurance company for payment. One important step that must be taken by the insurance company to avoid this type of situation involves the implementation of a proactive versus reactive approach.  

Northwood has proven that a proactive approach to assuring injury relatedness of prescriptions saves both time and money for the insurance companies it partners with. As a third-party administrator (TPA) of auto no-fault claims, Northwood acts as a Pharmacy Benefit Manager (PBM) for insurance companies to implement a pre-authorization system for all prescriptions. This approach ensures that each prescription submitted for payment within a no-fault claim is injury related which eliminates unnecessary costs for the insurance company. Northwood is an experienced PBM and partners with numerous insurance companies in Michigan to implement these proven procedures within their no-fault claims administration. 

Furthermore, when claimants choose a pharmacy services provider within Northwood’s expansive network there is no out-of-pocket cost to claimants for their filled prescriptions. Additionally, each provider participates in a rigorous credentialing process to ensure the highest level of quality is offered to each claimant and to provide the lowest cost to both claimants and insurance companies. This extensive network and the elimination of cost to claimants combine to provide savings along with significantly increased claimant satisfaction levels. 

For more information about avoiding prescription errors commonly associated with automobile no-fault claims please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 at your convenience.   

For more information https://www.northwoodinc.com/avoiding-prescription-errors-within-no-fault-claims/

Who Really ‘Benefits’ From Benefits Management

Many benefits managers exist within the realm of the insurance industry. With the multitude of benefits management options available to an insurance company, the question of who really benefits from this relationship arises. In the case of insurance companies administering claims involving claimant use of durable medical equipment (DME), a durable medical equipment benefits manager (DBM) has the ability to bring several positive changes to the insurance company and its claimants. 

A DBM works with an insurance company to administer claims that include the use of durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS). The most common concerns for insurance companies with these types of claims include overall claims cost, claimant satisfaction levels and the quality of claimant care. Northwood is a highly trusted and experienced DBM that addresses these common concerns and offers additional advantages to the insurance companies it partners with.  

The ever-increasing cost of DMEPOS claims can be mitigated through a variety of proven tactics implemented by Northwood. One such cost-saving measure centers around the provider network curated by Northwood over its more than two decades of experience as a benefits manager. More than 5,800 provider locations exist within this network that encompasses all of the United States in addition to Puerto Rico. Providers undergo a rigorous credentialing process in order to be accepted into the network and must participate in a re-credentialing process each year.    

Insurance companies working with Northwood as their DBM will enjoy negotiated fee schedules that help reduce their claims costs. Claimants have access to the entire network as well and because of Northwood’s pre-authorization process on all DMEPOS claims do not need to pay out of pocket for medical services. This pre-authorization review allows Northwood to assure that all prescribed DMEPOS services are directly related to the claim and therefore necessary expenses to the insurance company.  

Since Northwood reviews each provider request for injury relatedness and also ensures only the highest quality providers are accepted into its network, the level of accuracy within DMEPOS claims increases as well. Fewer errors and the elimination of non-injury related treatments and expenses also translates into an increase in the quality of care that claimants receive. These benefits therefore naturally raise the level of claimant satisfaction with DMEPOS claims.  

After examining the top concerns of insurance companies administering DMEPOS claims, it is clear who actually benefits from benefits management. First and foremost, claimants realize significant improvements such as better quality of care because of a partnership with a DBM. Insurance companies also experience significant improvements due to the reduction of claims costs and the significant increase in claimant satisfaction levels.  

For more information on partnering with Northwood as a benefits manager, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771. 

Achieving Exceptional Experiences For Michigan Auto No-Fault Claimants

Automobile accidents occur frequently and claimants experience both minor and catastrophic injuries stemming from auto accidents. In fact, the Association for Safe International Road Travel states that over two million people are disabled or injured in auto accidents in the United States each year. According to the Michigan State Police, there were over 74,000 auto-related injuries in 2015 in the state of Michigan alone. Insurance carriers face some challenges when it comes to these injuries within auto no-fault claims but also have the opportunity to provide exceptional experiences for their claimants.

The claims process can be rather complicated and a major source of frustration for claimants, especially when multiple parties are involved. Those auto no-fault claims involving claimants with catastrophic injuries contain additional complexities that an insurance company must take care to handle in an expedient and efficient manner. When claimants sustain injuries in an auto accident, they will experience a higher level of satisfaction when their insurance company offers the smoothest claims adjudication process possible.

An insurance company’s adjusters must ensure that all claimants are properly indemnified while simultaneously managing the cost of the overall claim and assuring that claimants are satisfied with the claims process. These important facets of an auto no-fault claim add to the administrative burden of adjusters which can ultimately increase the amount of time needed to complete a claim.

In order to ensure that claimants are indemnified and have an exceptional experience throughout an auto no-fault claim, insurance companies should consider working closely with a third-party administrator (TPA) such as Northwood. A TPA will be able to streamline the claims process for both claimants and adjusters by eliminating the need for claimants to pay out of pocket for auto-related expenses.

Northwood has curated an extensive network of providers that spans the entire United States, including Puerto Rico, to provide easy access to home health care services for claimants. When an injured claimant is prescribed medicine for their injury, for example, Northwood will ensure the prescription is auto-related before approving payment to the provider and the claimant will receive the required drugs without paying out of pocket. This pre-approval process is not only convenient for the claimant but also reduces this administrative burden for the adjuster. Claimants will receive their auto-related treatments more quickly and experience a higher level of satisfaction with their claim because of this pre-authorization process.

In addition, Northwood operates a call center for the convenience of claimants. The call center is staffed with highly trained personnel that help monitor claimant satisfaction. The staff members in the call center also provide language services for those claimants that may need assistance with translation which provides an added benefit to claimants.

By working with Northwood on automobile no-fault claims, insurance companies can rest assured that their claimants will have exceptional experiences. For more information on additional ways that Northwood assists with increasing claimant satisfaction, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771. 

Maintaining Good Health As We Age

In your 20s you felt on top of the world. In your mind you were invincible, able to take whatever came your way. As you began to leave your 30s and enter your 40s, the word invincible became less of a symbol of yourself and more of a wish. Aches and pains might have started setting in, you find recovery from injury might take longer, and some mornings your get up and go has got up and went without you. Getting older is a part of life. While there is nothing we can do with the aging process, there are steps that we can take to help ensure a healthier future.

Regular Check-ups

It is important as we age to visit the doctor to get a regular check-up. You speak with them about your family medical history, changes you’ve seen in your body and ability, and share with them any concerns that you have. Seeing the doctor regularly can help you realize where you are health-wise and track changes that your body goes through as you get older. You can track your weight and blood pressure, for example, to be alerted to any sudden changes.

Medication

As we age, we become a little more lax about taking our prescribed medicine as directed. The doctor will prescribe medication for blood pressure, blood sugar, or other conditions and some people figure it is more of a guideline than a rule. When medication is not taken regularly therapeutic doses cannot be maintained, and the medication will not be able to do its job properly. If the person is not honest with the doctor about how often they are really taking the medication the dosage may be adjusted if the doctor feels it’s not working. Then they are now taking the wrong amount, which could cause further issues.

Move It

It is very important to maintain mobility and flexibility for as long as possible. This can help prevent falls, lead to more enjoyment in life, and help a person maintain their independence. While you may or may not be able to run a four-minute mile still, making sure you get out for a walk, take an exercise class, or stay active with friends are all good ways to maintain your activity level.

Lifeline

Another important factor for healthy aging is to maintain relationships with family and friends. Sometimes older people have a tendency to close themselves off from others and become reclusive. By keeping in touch with family and friends, you will let someone else know how you are doing. Someone should be designated your emergency contact and have all of your medication information should it need to be given to a third party if you are unable.

Watch Each Other

If you have a significant other in your household, keep an eye on them to check for signs they are struggling. Sometimes people maintain the idea that they are “okay” when they are not because they don’t want to worry someone else. By checking in with each other and being honest about the challenges and changes that your body is going through you can help each other live the best life possible.

Visit our website at, https://www.northwoodinc.com

Workers Comp Pharmacy Benefit Management by NorthWood

Northwood has an extensive history of being an integral part of a number of health plans benefit administration for durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS).

Health plans, whether large, small or self-funded, have looked to Northwood to assist in the effective administration of their DMEPOS benefit to provide significant savings and member satisfaction. Pharmacy Benefit Management (PBM) programs have allowed health plans to achieve greater cost control in the area of pharmaceuticals.

Northwood has modeled its DMEPOS administration after the strengths of the PBM strategy.  Similar to what a PBM does for managing pharmacy benefits, Northwood does for the management of DMEPOS benefits.  Our Durable Medical Equipment Benefits Management (DBM) model creates a transparent program that enhances the value of DMEPOS benefits, while reducing overall costs and improving patient care.

Northwood offers health plans tailor-made solutions to best address their organization’s specific DMEPOS management, payment processing and cost containment goals.

Auto No Fault Benefit Management Services by Northwood

Northwood has an extensive history of being an integral part of a number of health plans benefit administration for durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS).

Health plans, whether large, small or self-funded, have looked to Northwood to assist in the effective administration of their DMEPOS benefit to provide significant savings and member satisfaction. Pharmacy Benefit Management (PBM) programs have allowed health plans to achieve greater cost control in the area of pharmaceuticals.

Northwood has modeled its DMEPOS administration after the strengths of the PBM strategy.  Similar to what a PBM does for managing pharmacy benefits, Northwood does for the management of DMEPOS benefits.  Our Durable Medical Equipment Benefits Management (DBM) model creates a transparent program that enhances the value of DMEPOS benefits, while reducing overall costs and improving patient care.

Northwood offers health plans tailor-made solutions to best address their organization’s specific DMEPOS management, payment processing and cost containment goals.


Northwood offers health plans tailor-made solutions to best address their organization’s specific DMEPOS management, payment processing and cost containment goals.

For more information visit our website at, https://www.northwoodinc.com/auto-no-fault/benefit-management/

Auto No Fault Pharmacy Benefit Management

Northwood has an extensive history of being an integral part of a number of health plans benefit administration for durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS).

Health plans, whether large, small or self-funded, have looked to Northwood to assist in the effective administration of their DMEPOS benefit to provide significant savings and member satisfaction. Pharmacy Benefit Management (PBM) programs have allowed health plans to achieve greater cost control in the area of pharmaceuticals.

Northwood has modeled its DMEPOS administration after the strengths of the PBM strategy.  Similar to what a PBM does for managing pharmacy benefits, Northwood does for the management of DMEPOS benefits.  Our Durable Medical Equipment Benefits Management (DBM) model creates a transparent program that enhances the value of DMEPOS benefits, while reducing overall costs and improving patient care.

Northwood offers health plans tailor-made solutions to best address their organization’s specific DMEPOS management, payment processing and cost containment goals.

Auto No Fault Pharmacy Benefit Management

FIVE REASONS WHY PHARMACY BENEFIT MANAGERS WORK BETTER

Worker’s compensation and automobile no-fault claims involving prescription drugs inherently contain several challenges for insurance companies. There are many ways to address these challenges, but the most effective involves a partnership between insurance companies and pharmacy benefit managers (PBM). This article will cover the top five reasons that PBMs work better than other options.

The first reason involves a significant impact on adjusters’ and examiners’ time. Experienced pharmacy benefit managers will be able to greatly reduce the administrative burden for adjusters and examiners by acting as a third-party administrator (TPA) of claims. By providing coordination of benefits with a claimants’ primary health insurance for auto no-fault benefits, a TPA allows adjusters and examiners to focus on adjudicating their claims efficiently and productively, eliminating the need for adjusters and examiners to spend their time on coordination of benefits related to copays and deductibles for auto no-fault benefits.

Secondly, a PBM will have negotiated discounted rates on pharmaceutical services for an insurance company and its claimants. These discounted rates are offered through a network of quality pharmaceutical service providers that an insurance company’s claimants have access to for all claim-related prescriptions.

Third, pharmacy benefit managers will be able to readily identify the appropriateness of prescriptions for an insurance company’s claimants. A pre-authorization process allows the PBM to ensure that all prescriptions being billed under a claim are directly related to that claim; once assured of injury relatedness, the claimant will pay no out-of-pocket cost for his or her prescription. Additionally, the PBM will identify the medical necessity of a dispense as written (DAW) drug and whether a generic drug is available and appropriate to substitute for the claimant.

The fourth reason a PBM is the best option for claims involving prescription drugs concerns the issue of compound medication billing. Pharmacies that are set-up to mix ingredients of medications that are customized for a specific patient are called compounding pharmacies. Compound medications are adjudicated differently since multiple medications are used in a recipe or formula in the compounded medication along with specialized equipment and pharmacy labor costs. Northwood processes claims according to a proprietary fee schedule in order to avoid unnecessarily high costs to the insurance company.

Finally, a PBM typically offers additional benefits to increase claimant satisfaction as well, such as home delivery services for prescriptions. If a claimant sustained catastrophic injuries while on the job or in an automobile accident and is unable to pick up his or her own prescriptions, a PBM will allow the appropriate prescriptions to be delivered directly to the claimant. This ensures the claimant access to the necessary medicine and increases claimant satisfaction with the insurance company.

These are but a sampling of reasons why a PBM works best for an insurance company administering workers’ compensation or automobile no-fault claims. Northwood has over 20 years of experience as a PBM and offers these benefits along with many more. If you have questions about the available benefits Northwood can offer to your company, please contact us at your convenience.

Visit https://www.northwoodinc.com/ to learn more. 

Auto Accidents Increase During Summer Months – Myth or Truth

People travel all year long. There are business travelers and people who travel for pleasure. There is an ebb and flow of the level of traffic during the year. The question becomes, are there certain times of the year where the auto accidents are greater? In this article, we will focus on the summer months. Is there an increase in accidents during the summer months over other times in the year?

During the summer months, children are out of school, and families go on vacation. This means that there is a higher level of traffic on the roads. Additionally, this can be a time when teenagers get their learning permits and practice driving. This also puts more people on the road and increases the number of inexperienced drivers.

People are generally more active in the summer months, so this means an increase in bicycles and pedestrians in the roadways. Also, kids are playing in their yards, so it is important to remain alert for the errant ball in the street. All of these equal more hazards for the roadways.

There has been an increase in distracted driving, mainly texting while driving. So, if there is an increase in hazards and a higher incidence of distracted driving, then the number of accidents will also increase. The summer months, due to the heat, increase the incidence of having a tire blowout. When that happens, the driver can lose control of the car and become a moving hazard for others on the road.

The National Highway Traffic Safety Administration has compiled statistics over the years that show that auto accidents increase during the months of August and September. The information above can offer a glimpse into why this could be. Knowing this information can help drivers be more vigilant when they are behind the wheel.

Everyone should always make sure they have their seatbelt fastened when in a moving vehicle. It is best to put the cell phone done or place it in driving mode when in the car. There are hands-free options available if the phone is used while the car is in motion. It is important before using the phone for any reason to determine if the phone use needs to be now, or if it can wait until the car is not in motion.

Remaining aware of the potential hazards while driving can help everyone be a safer driver. This is true for the summer months and all throughout the year.

 Visit https://www.northwoodinc.com for more information.

ISSUES IN ALTERNATIVE DRUG THERAPY

Complementary and alternative drug therapy is becoming more popular among consumers. CNN reports that in 2015, more than 33 percent of people in the United States were searching for assistance with their health issues from somewhere other than their primary medical doctor. These alternative treatments are typically used in conjunction with traditional medicine, but about five percent of the 89,000 participants in the National Health Statistics Report cited by CNN were seeking out alternative therapies to be used without prescription drugs.

While the benefits of alternative therapy are debatable, there are many more known issues and potential problems associated with it. The vast majority of available alternative drug therapy options are not regulated by the Food and Drug Administration (FDA) and may pose a significant risk to claimants due to the lack of industry standards for a particular therapy. Supplements and other alternative drugs taken orally may interact with prescribed medicines and cause health complications or even fatalities in extreme cases. These health complications and negative interactions may ultimately mean higher medical costs to an insurance company due to the additional recuperation time needed for their claimants with injuries from an automobile accident or workers’ compensation incident.

Northwood acts as a Pharmacy Benefit Manager (PBM) for an insurance company’s auto no-fault or workers’ compensation claims to assist in reducing claims cost and help minimize the issues that can arise with alternative drug therapies. By implementing a pre-authorization process for all claims involving prescription drugs, Northwood can help assure all claimant prescriptions are injury related. This not only eliminates unnecessary costs to the insurance company but also reduces the chance of drug interactions for claimants by connecting the claimant directly with a trusted pharmaceutical provider to help ensure prescription drug regimens are followed.

Highly qualified and extensively trained staff members are available each day at Northwood. The staff at Northwood is skilled in the use of prescription drugs and is familiar with types and dosage of drugs, further assuring the injury relatedness of all claimant prescriptions. Insurance companies and their claimants will also gain access to a network of high-quality, credentialed medical providers who provide discounted prescription rates for Northwood’s clients. This network spans the United States and Puerto Rico and allows claimants to receive their prescriptions without paying out-of-pocket costs. Claimants are also free to inquire of the pharmacy providers in this network about potential interactions with alternative drug therapies they may be using. Providing this resource for claimants allows for a significant reduction in drug interactions and helps hold down the cost of claims involving prescription drugs.

For more information regarding issues with alternative drug therapy or Northwood’s ability to help address and minimize the associated issues while saving money for insurance companies and claimants, please contact us at your convenience.

MICHIGAN’S AUTO INSURANCE AMONG THE HIGHEST IN THE NATION

Michigan residents are well aware that their auto insurance premiums are continuing to rise. According to the Detroit Free Press, auto insurance rates in Michigan have been steadily increasing since 2009. Insure.com reports that as of 2016, the state of Michigan has the costliest auto insurance rates in the entire United States. In fact, Michigan has had either the most or the second most expensive car insurance premiums for the previous six years in a row.

Numerous factors may play a part in these rising auto insurance premiums, but the largest variable pertains to Michigan’s unique automobile no-fault coverage. Many states in the nation offer a variation of auto no-fault coverage for their clients, but Michigan is the only state in the U.S. to provide unlimited no-fault coverage for those injured in an auto accident. Furthermore, injured claimants are eligible to receive payment for up to three years of covered wages if they were unable to return to work due to injuries sustained in an auto accident. This generous auto no-fault coverage comes at an incredibly high cost, both to insurance companies and their insureds. The Detroit Free Press reported that insurance companies in Michigan incurred nearly three billion dollars’ worth of costs for the 44,620 no-fault claims in 2012.

While the state’s no-fault coverage may play a significant role in the rising cost of auto insurance, the advancing technology and rising costs of medical treatments and prescription drugs also affect Michigan residents’ premiums. Customized wheelchairs and other rehabilitation equipment are sometimes prescribed for injured claimants, for example. Insurance companies can quickly see a rise in overall auto no-fault medical claims costs if they are not proactive in controlling expenses.

Insurance companies may not be able to bring immediate change to Michigan’s no-fault laws or control the costs of rapidly advancing technology, but they do have an option to help hold down auto insurance rates for their claimants. Northwood is a trusted and highly experienced third-party administrator (TPA) of auto no-fault claims and can assist insurance companies with the rising costs associated with these claims. Through its credentialed and extensive network, Northwood offers insurance companies the opportunity to provide reduced rates on medical services to their claimants, with no out-of-pocket cost involved. Northwood also offers highly trained customer service staff members who are available 24 hours per day and seven days per week, ensuring high levels of claimant satisfaction.

By partnering with a TPA such as Northwood, insurance companies will realize significantly reduced auto no-fault claims costs. As these cost-saving measures are implemented, insurance companies will be better able to hold down further increasing auto insurance premiums for their insureds. Proactive management of no-fault claims is vital to an insurance company’s success, and representatives from Northwood are available to assist with providing additional information.

Reference: https://www.northwoodinc.com/michigans-auto-insurance-among-highest-nation/