MMA Blog

Streamlining Claims Process Can Save Costs for Hospitals

Healthcare organizations are experiencing a sharp rise in premiums. As one of the largest brokers in the region, we are focused on looking for the correct markets and insurance partners for our hospital clients to make sure that the increases we are seeing are in line with their competitors.

There are two key areas where we work with clients to proactively control insurance costs: Claims Advocacy and Risk Management.

 

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Claims happen - how they're handled can impact your bottom line

Claims can be complicated and messy.  Following best practices to streamline the claims process and communicating frequently can lower the total size and cost of your claim, controlling one element to future premium increases.  We use claims advocates to help walk our clients through the process from initial claim filing to successful resolution. It can also include education about when and how to submit a claim.  In one case, rather than submitting an initial claim for failing facilities equipment that caused a power outage, a hospital facility made repairs to equipment that subsequently failed later.  Because replacement parts were used, the cost of replacement wasn’t covered.  Through open and proactive communication, we work with clients to help them understand both immediate and long-term cost factors when submitting a claim.

 

Preventative Care for Claims - Risk Control

What is true in medicine is true in insurance – preventative care lowers risks and lowers costs.  We work closely with industry experts to spot and correct potential issues with the goal of limiting the number of large and catastrophic claims.

For a large regional hospital, we took an active role in improving both the overall safety of its facility and establishing a solid safety culture.  After reviewing their claims history and carrier reports, touring facilities and analyzing current training, our safety and risk control experts met with hospital leaders several times a year to address problems areas, make changes to work area configurations and improve training. The result was not only a safer environment for staff and patients, but also a solid bottom line impact.  Because of these changes, the hospital was able to lower the number of safety events and claims.  The outcome: the hospitals worker’s compensation rates were cut in half, even though the employee count almost doubled during the same time.

Continually looking at a hospital facility with a laser focus on safety, can create a culture where all employees take ownership of this important task.

With proactive risk management and risk control, our goal is to position your hospital a level above your competitors when being evaluated by underwriters.   We cannot control all of the market forces that are leading to premium increases, but at the end of the day, your claim history will be a significant factor of your premium amount.  Whether through in-house staff or alignment with strategic insurance partners, implementing these strategies that can make an impact on current claims cost, help prevent future incidents, and create a more financially sustainable insurance program.

 

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