Several clients and a former employer use Broadspire with excellent results on nationwide accounts. Broadspire is perhaps better known as “Crawford & Co” as that was their name for many years. Recently, I had the opportunity to tour a Broadspire claim operations and was very impressed. Here are a few things I learned.
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“How Do I Get My Adjusters To Follow My Account Handling Instructions?”
Here are 10 top criteria recommended for reviewing when considering the selection of TPAs.
- Internal Audit Procedures: How does the TPA ensure internal quality control and correct any problems when they arise? Do they have a proactive internal audit program where all offices, and adjusters must meet high quality standards? Are files from every adjuster audited?
2. What are the Best Practices? Do they achieve > 80% of their best practices. Ask to see how the offices and adjusters are scored.
3. Do they provide administrative assistance for adjusters for tasks such as obtaining medical records, paying bills, setting up files, filing all forms, preparing for claims reviews, getting “one-step” prints, etc. This frees time for the adjusters to handle more complex responsibilities.
4. Will they provide dedicated adjusters – so you can have the same adjuster(s) handling all of your claims?
5. Are senior adjusters handling catastrophic claims and fatalities?
6. Do they have established relationships with investigators nationwide which can be used in all locations?
7. Do they encourage quarterly on-site claim reviews and/or regular (perhaps weekly) telephone “roundtables?”
8. Do the Plans of Action (POAs) include specific action steps? Not just, “get employee back to work.”9. Do adjusters have “e-triage” questionnaires (that can be customized) for the uniform development of information during Three-Point Contact? The e-triage claim assessments identify potential obstacles to return to work and recovery, and provide suggested next steps.
10. Is medical management well-integrated and available? Does medical management include Senior Nurse Reviewers and MDs for peer-to-peer on a claim-by-claim basis when needed?
Author: Rebecca Shafer, J.D. consults for mid-market and national accounts focusing on project management, risk management assessments, data review, benchmarking, and development of Workers’ Compensation and Injury Management Programs. Projects focus on development of training and education programs, document design, evaluation and integration of insurance claims administration and TPA services. Contact her are: [email protected] .
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