Voluntary Provider Network Management Solutions

Decision Point®: Voluntary Provider Network Management Solutions—Your Prescription for Superior Claims Results

Voluntary Provider Network Management Solutions

Leading property and casualty insurance carriers are continually looking to achieve better injury claim outcomes specifically increasing claim handling efficiencies, controlling costs and enhancing customer satisfaction. Top carriers help achieve these goals via offering the benefits of Voluntary Provider Networks (VPN) also known as Preferred Provider Organizations (PPOs) to injured parties.

Integrating VPNs in to injury claims handling delivers benefits to:

  • Injured parties—by giving them access to a wide variety of general and specialized quality medical providers at less cost to their benefits ensuring they receive the most appropriate medical treatment required;
  • Medical providers—by helping to ensure a more consistent stream of patients and lessening of potential billing disputes and payment delays; and
  • Insurers—via fully integrated workflows, removal of administrative tasks, reduction of potential bill dispute negotiations and ensuring the reimbursement is fair and reasonable.

Get Fast-Acting and Lasting Results with DecisionPoint® Voluntary Provider Network Management Solutions

Mitchell has developed high-technology software applications and partnered with leading VPNs to develop and deliver the benefits of a fully managed and optimized VPN solution. Far beyond just providing VPN integration services, the Mitchell solutions empowers DecisionPoint users to:

  • Achieve a fully integrated and modern medical bill review technology solution that is compliant with standard HIPAA and ANSI X12 data transmission requirements and able to support customer specific rules through integration with DecisionPoint Sentry™ and DecisionPoint Claimant Treatment Guide™
  • Configure pre and post bill review processes and workflow by office and/or jurisdiction to ensure VPNs are utilized in the most optimal way possible.
  • Provide automatic access to outcomes-oriented providers that improve injury resolution while preserving the injured party's medical benefits
  • Accelerate claims adjuster efficiency by removing "receive, review, recommendation & reimburse" processes
  • Optimize the achievement of appropriate straight-through processing for medical bill review and payment—inclusive of full provider inquiry support
  • Achieve transparency into the management of medical bills resulting from injury claims via daily electronic updates to help ensure medical benefits are extended only on appropriate claims and maintained within policy limits
  • Obtain the results of the leading, fully optimized nationwide, regional, or local VPN providing "best-of-the best" VPN access by jurisdiction, without the need or cost to develop and maintain specialized business workflows or system integrations specific to each individual VPN
  • Achieve the benefits of working with a premier, single source partner, in Mitchell, who manages all:
    • Contractual relationships with partners
    • Service level agreements
    • Provider inquiries
    • Partner communications
    • Invoicing
    • Reporting

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