Within the field of claims administration, there are many avenues that insurance companies may choose to take to assist in holding down costs and in lessening the administrative burdens placed on adjusters and examiners. One such avenue that brings a multitude of benefits to an insurance company is to partner with a third-party administrator (TPA) on each claim, whether auto no-fault or workers’ compensation claims.  

Rising Costs In The Insurance Industry: What Can Be Done

With a new year comes additional challenges for insurance companies administering both workers’ compensation and automobile no-fault claims. Continually rising costs for prescription medications as well as durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS) bring ever-present challenges and obstacles for insurance companies to work around. While there are several factors that figure into the increasing costs, the most important thing for insurance companies to focus on involves ways to mitigate the cost challenges within their control.

As an experienced third-party administrator (TPA) of auto no-fault and workers’ compensation claims, we at Northwood recognize these challenges and have compiled four ways that will assist insurance companies in addressing this problematic topic.  

The first and most efficient way to combat the ever-rising costs in the industry is to partner with a TPA. Each claim administered by your insurance company will benefit from the thorough and objective review provided by the TPA. Innovative procedures developed through years of experience translate to savings for insurance companies.  

Secondly, insurance companies will reap significant cost savings within claims administration by gaining access to discounted rates on DMEPOS services and prescription medications. Building a network of providers that agree to lower rates does take an enormous amount of time and effort. Fortunately, a TPA with its own network of trusted providers will offer access to this network to your insurance company as well as your claimants.  

Download our PDF to continue reading and see additional solutions for reducing costs.

A third method to battle rising costs involves implementing a pre-authorization process on each and every claim. The frequency of overpayments and payment of non-injury-related services will be greatly reduced by pre-authorizing every medication and treatment for each claimant. Claimants will still have access to the appropriate care they need yet insurance companies will avoid paying for treatments and medications that do not fall within the scope of the claim.  

Finally, bundling of Healthcare Common Procedure Codes (HCPCS) during the pre-authorization process is essential to saving money for your insurance company. Many providers unbundle components of DMEPOS services in an attempt to receive a larger payment from the insurance company. Northwood’s process of rebundling procedure codes reduces costs for your company.  

It is more important than ever for insurance companies to control costs. Partnering with a TPA, accessing a trusted provider network with discounted rates, implementing pre-authorization and bundling HCPCS codes are all essential to saving your company claims dollars. Northwood will bring its decades of experience to your company and save you time and frustration in the process. Please call Rosanne Brugnoni at 586-755-3830 ext. 3771 to discover additional solutions that are customized to your needs.

Clarity In Billing Improves The Bottom Line

A seemingly endless variety of factors contribute to increased claims administration costs. Whether your insurance company administers automobile no-fault claims or workers’ compensation claims, it is essential to always take a proactive approach to controlling the cost of claims. An important topic to address within your company concerns the matter of clarity, or lack thereof, in billing. Overall, achieving clarity and transparency in billing can improve the bottom line.

A major opportunity to achieve greater clarity in billing pertains to building a trusted network of providers. It is vital to both the bottom line and to claimant satisfaction to provide access to high-quality medical providers. This can be a very time-consuming avenue and can also be very difficult to achieve, so insurance companies will save both time and money by partnering with an experienced third-party administrator (TPA) that has already taken the initiative to build a credentialed network of providers. Furthermore, the network of providers should be expansive enough to serve claimants all over the United States and also provide discounted rates to both the insurance company and its claimants.  

These providers that are in the TPA’s network and that agree to give the insurance company discounted rates should also offer access to prescription medicines at no out-of-pocket cost to claimants. Claimants who are given the opportunity to obtain their injury-related prescriptions without the need to pay up front or submit reimbursement requests to their insurance company tend to report much higher satisfaction levels with the claim and with the insurance company itself. Therefore, the elimination of out-of-pocket claimant costs contributes to increased clarity in billing that further impacts the bottom line.  

Insurance companies can also look to the Healthcare Common Procedure Coding System (HCPCS) for an opportunity to achieve more clarity in billing. The HCPCS procedure codes are notoriously complex and inherently provide the potential for overpayments to providers. Additionally, some providers may use not otherwise classified (NOC) codes frequently in an attempt to request higher payments from the claimant’s insurance company. Access to an experienced TPA that has the knowledge and resources to review and bundle these codes together where appropriate can significantly increase clarity in billing and reduce costs to the insurance company.  

At Northwood, we are committed to providing excellence to the insurance companies that partner with us. We offer a trusted provider network, discounted rates, the elimination of out-of-pocket claimant costs and our extensive experience with HCPCS procedure codes and bundling.

For a more customized look at the ways Northwood can help you achieve more clarity in billing and improve the bottom line, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 to schedule a meeting.   

Get A Jump Start On Controlling Costs This Year

As adjusters and examiners are reviewing claims statistics and planning for 2018, take a look at some of these challenges and associated suggestions that are designed to help you get ahead on controlling costs for the coming year.

With every claim comes unique challenges and situations that are complex. Claimants who sustain catastrophic, orthopedic or soft tissue injuries because of a workplace incident or an automobile accident may require anything from surgeries to home health care services. These types of claims represent additional challenges because many providers choose to unbundle the Healthcare Common Procedure Coding System (HCPCS) codes.  The best practice on all claims is to reduce unbundling and the use of not otherwise classified (NOC) codes to increase transparency and reduce the chance of your company paying too much.

Discounted rates are vital to the success of an insurance company as well. The average wholesale price (AWP) of prescriptions is continuously rising as you have likely observed within claims you administer that require the use of claimant prescription medications. While you may not have the ability to control those prices, you do have the option of negotiating discounted rates for your company.

Those same providers that agree to give your company discounted rates could also offer access to prescription medicines at no out-of-pocket cost to your claimants. This suggestion has a more indirect impact on saving claims costs. When claimants are offered the opportunity to fill their injury-related prescriptions without the need to pay up front and submit reimbursement requests to their insurance company, their satisfaction with the claim and with the company increases significantly. Over time this translates into increased claimant loyalty and additional premium dollars for your company.

These are things to consider as you look toward the remainder of 2018. The most efficient and practical way to implement these ideas and solve the challenges outlined above is to form a partnership with a third-party administrator (TPA) of both workers’ compensation and automobile no-fault claims. Northwood is one such TPA with more than 20 years of experience in saving money for insurance companies.

At Northwood, we strive to bring proven processes and procedures to our clients and their claimants. From an expansive provider network offering discounted rates and the elimination of out of pocket payments for claimants to pre-authorization processes and the practice of transparency in HCPCS use, Northwood brings innovative solutions to your company.

For a more customized look into how Northwood can help you get a jump start on cost savings for 2018, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771 to schedule a call.

Benefits Of Working With An Experienced Third-Party Administrator

Insurance carriers administering automobile no-fault and workers’ compensation claims that encompass claimant use of durable medical equipment, prosthetics and orthotics services (DMEPOS) find themselves facing several challenges, especially in regard to claims involving multiple services and treatments.  

The Healthcare Common Procedure Coding System (HCPCS) is utilized by providers to code services and equipment used in claimant treatment regimens and request payment from insurance companies. The complex nature of HCPCS represents the potential for rising claims administration costs and overpayments to providers due to the common practice of unbundling services. Fortunately, a third-party administrator (TPA) such as Northwood is able to assist in minimizing costs and challenges. The following are three commonly seen challenges with unbundling along with efficient solutions that help mitigate them.  

One such challenge pertains to providers unbundling services since HCPCS procedure codes are available for individual components. The process of unbundling increases the number of claim lines and unnecessarily increases costs for insurance companies. Bundling services will have the opposite effect and assist insurance companies in reducing costs.  

Secondly, providers that unbundle services and utilize more claim lines also typically generate additional paperwork for adjusters and examiners. In contrast, the process of bundling actually significantly reduces the paperwork for insurance companies. This, in turn, allows adjusters and examiners to more efficiently administer claims which contribute to a reduction in claims administration costs.  

Finally, the use of not otherwise classified (NOC) codes drives up the cost of claims for insurance companies. With the thousands of HCPCS codes available there is almost always an accurate code to use for each and every procedure. The use of NOC codes represents an opportunity for insurance companies to greatly minimize them by partnering with a third-party administrator.  

While these three challenges are significant, working with an experienced TPA can mitigate these issues. Northwood has partnered with insurance companies for more than 20 years to proactively manage claims. We execute a pre-authorization process to reduce the utilization of not otherwise classified (NOC) codes, increase transparency and reduce unbundling. Insurance companies can confidently partner with Northwood as their DBM to assist with reducing claims costs due to unbundling. For additional information, please schedule a meeting with Rosanne Brugnoni at 586-755-3830 ext. 3771.

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 is a growing topic of discussion in general but specifically within the field of workers’ compensation claims.

Avoiding Prescription Errors Within No-Fault Claims

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.

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.

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.