New work comp medical cost containment program delivers savings, clinical intervention and transparency.
“Traditional medical cost containment program results are plateauing, yet payers are still losing between three to five million dollars in savings for every $100 million spent on medical services,” said Mary O’Donoghue, MedRisk’s Chief Product Development Officer. She noted that approximately seven percent of medical payments are improperly paid.
NexGen Advantage is the industry’s first single solution that uses analytics and technology to identify and deliver the best combination of strategies to ensure accurate and fair medical payment of individual bills. “NexGen leverages the buying power of a mega network with more than 900,000 providers, an incredibly powerful data analytics system, and expert clinical intervention to capture additional savings after bill review, make payers’ lives easier, and improve provider partnerships,” O’Donoghue added.
NexGen Advantage runs a payer’s bill data through a sophisticated analytic that examines a number of factors, including jurisdiction, bill type, facility, and provider type. There is a single, flat access fee. Taking each payer’s business objectives into account, the program determines where a preferred provider organization is most effective and where other cost containment strategies are best for all parties.
Online access to data and peer-to-peer conversations with providers about benchmarking, coding and payments help to reduce provider confusion.
“NexGen Advantage supports a partnership between payers and providers by delivering full transparency for fair and appropriate payment, “O’Donoghue said. “This is particularly important as the industry looks toward building stronger, outcomes-oriented networks.”
MedRisk is the leader in physical rehabilitation solutions for the workers’ compensation industry. Founded in 1994 and based in King of Prussia, Pa., MedRisk is accredited under URAC for utilization management and has successfully completed a SSAE 16 Type II examination. MedRisk’s programs deliver savings and operational efficiencies that are significantly greater than traditional programs. Customers include insurance carriers, self-insured employers, third-party administrators, state funds, and case management companies.
To make a referral or obtain more information, visit www.medrisknet.com or call 800-225-9675.
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