Situation

After years of managing their own workers’ compensation claims, a large utility company decided to outsource their program to a third party administrator. This change would allow them to spend more time on return-towork issues and non-occupational absences for their staff, which totaled nearly 20,000 employees. As a selfinsured employer operating in several states, they needed knowledgeable medical case managers and claims adjusters who could work well as a team to control their workers’ compensation costs.

Action

The client selected Avizent to administer their workers’ compensation claims and oversee the medical case management responsibilities. At that time, Avizent took over many of the claims processing duties previously handled by the client. Among the services that they value the most are the bi-weekly claim reviews provided by Avizent’s claims adjusters. Through ongoing, regular communications, Avizent’s staff keeps the client thoroughly informed and up-todate on all claims activities, such as injured workers’ upcoming treatments and independent medical exams. The client has also benefited from Avizent’s experienced medical case managers who work hard to control costs and get injured workers back on the job in a safe, timely manner.

In addition, as an employer who self-administered their own claims, the client was used to having complete access to all of their claims information. With Avizent’s risk and claims management software, they have access to all claims data and can quickly develop claim reports for various business units as needed.

Results

This company has worked with Avizent for nearly a decade. During that time, they have expanded Avizent’s claims service coverage from four states to 12 states, which now encompasses the client’s entire operation.

Avizent’s efforts have produced substantial savings in many areas—most notably in medical managed care services. Through the efforts of Avizent’s talented claims adjusters and medical case managers, the client saw a one-year average net savings of nearly 50% on medical fee bills. During the same one-year period, Avizent saved the client more than $3 million on medical bills, with the highest savings achieved through Preferred Provider Organization network services. The total savings resulted in a 34-to-1 average return on investment (ROI). The average ROI and net savings include all of the client’s locations as well as all types of medical bills.

Avizent’s team of dedicated, skilled professionals consistently provides high-quality services and strives to exceed expectations. The client recognizes their efforts and is pleased with Avizent’s responsive, knowledgeable staff. They also appreciate Avizent’s claim reporting software, which has become a valuable tool for their business.