The largest workers’ compensation carrier in a single state was not able to stay competitive to gain additional market share. Handling bills internally was no longer scalable because they did not have the staff knowledge to expand into new states.
Consolidating the program was instrumental in their growth strategy. An integrated program leveraging Enlyte bill review with network optimization, pharmacy benefit manager and utilization review ensured all the gaps were filled. Each bill regardless of state is filtered the same way through a very consistent process.
The leadership now has visibility into all the data to make better business decisions. The partnership has allowed them to keep up with growth and volume.
$181k in Added Bill Review Savings
Reduced Claim Staff from 9 to 2 People
17% Increase in Pharmacy Savings
Enlyte hears what we need and what our challenges are, and they provide us a solution we can then put into place.VP Medical Management, Regional Carrier