Stop-loss insurance carriers and managing general underwriters (MGUs) are in a peculiar position in reducing claims costs. They can’t direct first dollar payment, but if they don’t help third-party administrators (TPAs) watch costs their loss ratios mount causing rates to rise. Most stop-loss insurance carriers and MGUs have found cost containment companies to refer claims to, however few have found companies they are willing to call their partners.
Choosing a cost containment partner is no easy task, especially when your partners regularly interact with your clients. This interaction is a risky proposition. When selecting partners stop-loss insurance carriers and MGUs should seek out those offering the right mix of services, workers with key technical competence and – most important – likable leaders with great people skills.
“Underwriting brings in the business, claims keeps it,” an old insurance adage reminds us. Claims departments must deliver superior customer service while at the same time walking the fine line between paying all the claims, which drive up the loss ratios, or denying all the claims, which scares all the clients away. Claims managers must strike a balance knowing when to pay and when to deny without being pennywise and pound foolish, always keeping in mind the customer and serving their policy.
Everyone wants superior customer service. Everyone promises superior customer service. Few actually deliver it successfully let alone repeatedly. That’s because customer service is very subjective. It is measured in the eyes and hearts of people and every person sees and feels differently about a given set of circumstances.
EthiCare Advisors, Inc. is committed to delivering superior customer service every day through high-touch, customized claims settlement. Every claim is handled, checked or reviewed by an owner. We deliver a level of customer service you simply cannot get by repricing a claim online or through EDI. Here are some of the ways we deliver superior customer service:
Customized sign-off letters for your organization. Each company is different with different needs and requirements. EthiCare Advisors works with your claims staff to develop customized provider signed releases to suit your needs. We can add specific terms and conditions, your unique claim or client number, or specialty compliance language.
Our ability to say no. Time is money. When we know we can’t help secure a discount, we let you know upfront. We do not to waste anyone’s time or resources. Our clients give us considerable respect for just saying “no.”
Our high level of contact. It is not uncommon for clients to call or email us six or more times in one day. They ask questions, inquire about discount relationships, make special requests, etc. We are always accessible. Every client has the cellular phone numbers for EthiCare Advisors’ owners, Mark and John.
Professionalism. When a carrier/MGU refers a claim to us, they are usually referring us to the TPA. We stress the significance that the TPA is the client of the MGU/Carrier and our demeanor reflects back to the MGU/Carrier. We treat your clients with respect and courtesy as you would expect to be treated.
Our commitment to customer service extends to our pledge to charge among the lowest fees in the industry. We only charge 15% of savings for out-of-network claims settlement – compared to the industry standard we are 40% less!
We NEVER access a blind network or silent PPO. Securing a signed release means we NEVER had a discount pushback on our settlements. This gives stop-loss insurance carriers and MGUs the piece of mind in knowing that when a claim is settled by EthiCare Advisors it is settled for good.
EthiCare Advisors offers you superior customer service through quality, customized options at low prices on the terms and conditions you want. Give us a try today. We promise you won’t be sorry.