Topical creams are becoming part of the mix of pain treatment options as doctors look for alternatives to addictive opioids.
Executive VP Dave Torrence explores how fragmented systems drive cost leakage in P&C claims, and how integrating clinical oversight, pharmacy management, payment integrity and network strategy can improve visibility, strengthen decisions and improve outcomes while reducing total claim spend.
When medical bill review is managed by internal teams, performance depends on sustaining specialized expertise and the ability to scale operations in the face of turnover, volume volatility and unexpected disruptions. For many payers, as bill volumes fluctuate and labor pressures increase, sustaining consistent turnaround times and maximizing savings can place growing demands on internal teams.
Not all durable medical equipment (DME) referrals are completed at purchase. Some include warranties that need to be monitored and maintained, including items like wheelchairs, respiratory equipment, prosthetics and patient lifts.
Expanded utilization review helped a self-insured employer control rising surgical costs, reduce unnecessary procedures, and generate over $1M in savings while maintaining a two-day review turnaround.
See Michele Hibbert break down the impact of new state legislation on AI-powered claims processes in this exclusive Business Insurance "Comp Spotlight" interview.
Read how New York's strategic utilization review expansion kept medical payments stable despite rising costs nationwide.