Medical Cost Containment

Containing rising medical costs is a key challenge for the workers’ compensation industry. These costs continue to increase at double-digit rates and now comprise approximately 60 percent of workers’ compensation claims expenses.

As medical inflation continues, insurance companies, risk pools, third-party administrators, and self-insured employers need effective software and services to help control healthcare expenditures and streamline the operational costs associated with reviewing, processing and paying medical bills.

To address these challenges, Aon eSolutions offers the iVOS insurance solution with total medical cost-containment capabilities that enable organizations to reduce their healthcare spending, as well as the administrative expenses associated with the bill review and case management process.

TOTAL MEDICAL COST CONTAINMENT

• Review software – a browser-based national medical bill review software solution that includes advanced workflow management and automation tools to enable clients to optimize savings and productivity for in-house bill review departments
• Review service – complete bill review service and expertise to review and re-price medical bills in accordance with state-mandated fee schedules and PPO contracts, handling everything – both medical and ancillary bills – and saving clients 50 to more than 60 percent on initially billed medical costs
• Case management software – a module to assist nurse case managers in coordinating cases, tracking treatment requests, directing injured employees to the most appropriate, cost-effective care, and facilitating a quick and safe return to work
• Case management service – full case management service including early intervention, utilization review, telephonic and field case management, and peer review services
• Document imaging – ability to scan bills into the system and attach them to corresponding claims, offering a “paperless” environment and streamlining workflow, virtually eliminates manual data entry, mail operations, paper shuffling, and cumbersome data transfers

Developed with extensive managed care “intelligence” and in collaboration with today’s leading workers’ compensation and insurance professionals, the system provides proven “out of the box” capabilities and the flexibility to embody your organization’s unique policies and procedures. iVOS has a phenomenal track record of success in helping clients to:

• maximize multiple layers of medical cost savings
• increase accuracy in the medical bill review and re-pricing process
• leverage expert staff, experienced in bill review, utilization review, and nurse case management
• ensure appropriate medical treatment is in line with today’s standard protocols
• improve workflow and efficiency, enabling faster turnaround on bills and prompt payment to providers
• enable seamless, hassle-free data conversion from previous bill review companies
• comply with the latest legislative updates to fee schedules and mandated turnaround times to avoid fines and penalties