The selection of an organization’s claim administrator is one of the most important decisions for a risk management department. It is vital to choose a claim administrator that can best take advantage of the programs unique to an organization to most effectively reduce the total cost of risk.
With the services and cost containment programs offered by claim administrators becoming far more complex over the past decade, a high level of expertise is required to collect and analyze the various service offerings. Marsh Risk Consulting (MRC) has the required expertise and experience with claim and managed care vendors and their service offerings, thereby enabling organizations to make the best vendor selection decision.
Service Highlights
MRC provides a claim and managed care administrator selection service that assists organizations in the selection of the claim and/or managed care vendor that will best meet their specific needs. Our process identifies the vendor that can best provide quality service, aggressive pricing, and both positive claim and medical outcomes.
The MRC Approach to Vendor Selection
MRC works with an organization to gain a clear understanding of its unique claim administration needs. Our consultants compile claim data, including volume and geographic location; identify organization-specific claim and customer service issues; and establish claim handling requirements and information technology system needs. Developing this understanding is integral to the creation of a customized request for proposal (RFP) for vendors as well as the final selection process.
MRC has streamlined the RFP process by maintaining a database of all major insurers and claim administrators with standard company information to allow for the creation of an RFP tailored to an organization’s specific needs. MRC then distributes the RFP to the market and conducts a thorough analysis of each potential candidate.
Along with the customized RFP, MRC provides an evaluation scorecard and project timeline to keep the selection process organized and on schedule, allowing for sufficient time to make appropriate decisions. MRC experts discuss and analyze an organization’s specific claims administration options, various capabilities, service areas, parent-subsidiary relationships, and management structures.
Depending on the needs of the organization, MRC also may host vendor oral presentations or conduct candidate office visits. Our analysis includes a pricing comparison for all lines, as well as an objective evaluation of the cost outcomes for workers’ compensation exposure using our proprietary software, Variable Cost of Risk Evaluator (VCORE). This allows an organization to make the most well-informed claims administrator selection.
The VCORE Advantage
VCORE, winner of the Business Insurance 2010 Innovation Award, was designed to provide clients with a consistent and accurate evaluation of claims administrator cost outcomes during a claims administrator or a managed care vendor selection.
VCORE assists with the identification of the workers’ compensation and/or managed care vendor(s) that can best improve financial outcomes. Since the variable cost is as much as 92 percent of the workers’ compensation total cost of risk, VCORE helps with the evaluation of the cost outcomes of each vendor and enables organizations to make a more informed selection decision.
One of Marsh’s proprietary evaluation tools, VCORE allows for the comparison of workers’ compensation claims administrators on the estimated net variable costs per year. VCORE uses data from the competing claims administrators and calculates an estimate of the anticipated workers’ compensation variable costs in medical bill re-pricing and claims administration fees.
Why Work With MRC?
Choosing the appropriate claims administrator is one of the most important decisions that an organization can make. Quality claims administration can decrease the total cost of risk for an entire organization by controlling claim cost, enhancing claim service, and improving the care of injured workers. By going through the vendor selection process with MRC, you will become familiar with the marketplace’s services and pricing. This means that you can negotiate and experience program improvements even if you decide to keep the business with the incumbent vendor.
Our team of claim professionals is dedicated to ensuring quality claim and managed care vendor selection. Every day our professionals work with the market and have extensive industry knowledge. Furthermore, VCORE is available only through Marsh and is the only product of its kind that can objectively compare medical cost outcomes and administrative costs for each competing vendor.