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You are here: Home / Medical Cost Containment / Newest Strategy is Stratified Custom PPO Networks for Workers Compensation

Newest Strategy is Stratified Custom PPO Networks for Workers Compensation

June 17, 2010 By //  by Director Leave a Comment

Broadspire, a Crawford Company and leading third party administrator of workers’ compensation claims, liability claims and medical management services, has introduced the BOLD network, a custom preferred provider organization (PPO) strategy that includes targeted selection of medical networks on a state-by-state basis to produce superior outcomes for clients.

“For decades, traditional PPO network solutions have been a steadfast component of the workers’ compensation industry. But while preferred provider discounts still help reduce claim costs, they do not completely address today’s complex challenges,” said Danielle Lisenbey, chief operating officer, medical management services. “Our new state-stratified, multi-tiered approach allows us to partner with the best network by region, industry, and sometimes even by company.”

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“The 6-Step Process To Determine Workers’ Comp Injury Causation”

The BOLD – Broadspire’s Original Landmark Design – network features:

  • Regional networks – Broadspire works to find the best network in each state or region. Regional networks typically have better relationships with local providers, which often translate into more favorable rates.
  • Specialty networks – Broadspire also contracts with special networks that concentrate on workers’ compensation needs such as durable medical equipment (DME) and physical therapy.

“Instead of casting a wide net in hopes of a good outcome, this level of customization can produce superior penetration rates and savings when compared to the rest of the industry,” Lisenbey said.

Included among Broadspire’s networks and partners are: Aetna, Align Networks, Black Diamond, Express Scripts, Healthcare Solutions, HFN, MedFocus, MTI, Next Imaging, Rockport, Signature Networks, Three Rivers, Total Medical Solutions, Universal Smart Comp and United Health. Broadspire’s PPO website, www.BroadspirePPO.com, features the ability to search for providers and networks by state.

In addition, through the use of objective metrics, Broadspire is able to identify needs and cost drivers to build network solutions that are unique and specific to clients. Some examples of cost-saving solutions include:

  • A DME formulary with integrated clinical protocols
  • Physical therapy protocols and utilization review guidelines
  • Diagnostic imaging & retrospective guidelines
  • Clinical home health guidelines and vendor integration
  • Coding methodology for medical and non-medical transportation.

“The key to our documented success is working with the right strategic partners and applying proprietary clinical intervention triggers to make the greatest difference in reducing claim costs,” Lisenbey said. “We measure our success by our ability to improve our clients’ bottom line, and our medical network strategy continues to evolve to meet the ever-changing demands of managing workers’ compensation costs.”

FREE DOWNLOAD: “The 6-Step Process To Determine Workers’ Comp Injury Causation”

About Broadspire: Broadspire, a leading international third party administrator for large self-insured organizations, offers a broad array of customized claim and medical management services designed to increase employee productivity and contain costs. Broadspire’s U.S. offering of workers’ compensation, auto and general liability claims administration, medical management and absence and care management, is available bundled or individually. In addition, Crawford provides liability, motor and property claims management services in Europe under the Broadspire brand. Broadspire is based in Atlanta, Ga., with a network of 85 locations throughout the United States (www.choosebroadspire.com) and Europe (www.Broadspire.eu), including the United Kingdom (www.broadspiretpa.co.uk).

About Crawford: Based in Atlanta, Ga., Crawford & Company www.crawfordandcompany.com) is the world’s largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with a global network of more than 700 locations in 63 countries. The Crawford System of Claims SolutionsSM offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines including property and casualty claims management, workers’ compensation claims and medical management, and legal settlement administration. The Company’s shares are traded on the NYSE under the symbols CRDA and CRDB.

Contact: Stephanie Zercher at 404.300.1908; stephanie_zercher@us.crawco.com

WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers’ comp issues.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

FREE DOWNLOAD: “The 6-Step Process To Determine Workers’ Comp Injury Causation”

Filed Under: Medical Cost Containment Tagged With: Third Party Administrators (TPA)

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