Situation

A large, global provider of professional, technology and management services with thousands of employees began experiencing poor service and longer than expected response times from one of their claims management providers. They began exploring other companies that could manage self-insured claims for their growing operation in the United States. The ideal partner would offer responsive workers’ compensation claims services as well as managed care program expertise.

Action

The client originally selected Avizent to manage its state fund claims program in Ohio. They were pleased with Avizent’s adjusters and decided to expand their claims service coverage nationwide. When the company made its decision, one of the key differentiators was Avizent’s ability to provide seamless service.

Initially, all claims data had to be transferred from the former third party administrator to Avizent. This critical process was completed quickly and smoothly using Avizent’s advanced technology. To ensure the entire account team had the necessary details to begin working with the client, a set of account-specific service instructions was also developed. This includes all account details, such as the client’s preferences in every aspect of the claims management process, contact information and banking details.

A top priority for the client was consistent communications—and they knew Avizent could meet their needs. The account management team initiates and encourages communication between Avizent’s adjusters and the client’s claims manager. When the client contacts Avizent’s staff with questions or concerns, they respond within 24 hours. The client values Avizent’s approach to customer service—with adjusters who take ownership of any issues or questions that arise on claims, research the details, and provide thorough, prompt responses for the employer, injured worker and providers.

Avizent also provides informational services, such as verifying codes from the National Council on Compensation Insurance, and offering return-to-work guidance and recommendations. In addition, when the client was ready to become self-insured in Ohio, Avizent was instrumental in helping them complete the application process and fulfill additional steps required by the state.

Results

Avizent’s high-quality managed care services have produced significant savings for the client. During the first six months with Avizent, they saved 49.5% on medical bills—an 18 to 1 return on investment. Avizent’s specialty networks, including a Preferred Provider Organization (PPO) and a diagnostic scheduling service, have also helped the company maximize medical savings. The specific areas where they experienced the most savings include doctor visits, hospital inpatient and outpatient fees, radiology and physical therapy treatments.

The client is benefiting from Avizent’s ongoing cost control strategies, dedicated staff and quick response times. They have noted how pleased they are with Avizent’s claims handling expertise, outstanding customer service and thorough communications. Recently, Avizent was also selected to manage the client’s liability claims nationwide.