The Hidden Costs of Administrative Complexity
Managing specialty services claims is a balancing act. Claims handlers juggle injured employee care with a heavy administrative workload—often coordinating across multiple vendors, tracking service timelines and addressing unexpected issues. These tasks create delays that reduce claims handling accuracy and inflate operational costs unnecessarily.
Nearly half of all claims lead to medical expenses ranging from $10,000 to $500,000, with the average claim costing $44,179 according to NCCI data. Adding to the complexity, the fragmented nature of specialty claims management creates substantial administrative burdens, draining valuable time and resources.
Claims handlers face significant challenges, including:
Complex Vendor Coordination: Spending countless hours identifying and managing multiple vendors to ensure services are acquired and delivered.
Lack of Transparency: Without real-time insight into delivery timelines, stakeholders lose track of key updates, leading to delays and inaccuracies.
Risk of Non-Compliance: Poor communication reduces visibility and increases the likelihood of injured employees going off track or failing to comply with care plans, risking even greater complications.
These operational roadblocks don’t just slow down the process but also lead to reduced precision in claims processing and higher operational expenses. This complexity becomes even more pronounced with catastrophic (CAT) claims, where costs can surge dramatically. Although CAT injuries account for only 1% of claims, they can consume 15% to 20% of total spend.
Efficiency Through Innovation
Instead of working harder to manage the chaos, Apricus Specialty Solutions ensures claims handlers work smarter. Our approach promotes process optimization, transparency and accountability, transforming administrative roadblocks into smoother operations.
Outdated multi-vendor coordination or poor customer service are no longer an option. A modern approach to specialty services management requires:
Structured & Automated Communication
Removing the guesswork with automated systems designed for precision service management. Giving every stakeholder clear and timely updates, ensuring all parties stay aligned and informed.Defined Service Standards
Established timing protocols and clear service delivery accountability, ensures consistency and reliability throughout the process.Proactive Problem Prevention
Identify and address potential issues before they escalate. Proactive alerts notify of potential risks, such as patient non-compliance or delays, allowing swift intervention to keep claims on track, improving outcomes while controlling costs.
Operational Excellence in Action
By using Apricus services, you receive unparalleled support, ensuring better use of resources while maximizing return-to-work potential.
Unmatched Expert Support
Apricus connects claims handlers to a live expert in an average of just 10 seconds, delivering prompt and efficient support exactly when it’s needed. Our knowledgeable team provides 24/7 assistance, offering valuable insights to optimize resource use and enhance treatment outcomes.
Strategic Time Savings
Comprehensive automation and streamlined workflows drastically reduce the back-and-forth efforts that cost time and money. Claims handlers can dedicate more of their energy to helping the injured employee while minimizing operational costs.
Pre-Billing Approval and Prompt Provider Payment
Pre-billing approval process ensures accurate billing, prevents disputes and minimizes administrative burdens. By promptly reimbursing providers upon service, Apricus strengthens relationships and maintains a robust network.
Unleash Your Path to Success
By leveraging proven systems and a committed workforce, you can immediately elevate care standards while boosting efficiency. Our approach doesn’t just address administrative inefficiencies—it transforms them into opportunities for streamlined operations and cost savings. Ready to transform your specialty claims process? Contact Apricus today.