克里斯·威廉姆森
产品管理高级经理
对于理算员来说，第三方索赔可能具有挑战性, 所以我们邀请了克里斯·威廉姆森, 米切尔公司产品管理高级经理, 解释一些亚博真人官方版APP，使过程运行得更顺利一点.
汤姆 克尔(TK): 克里斯，欢迎来到播客.
克里斯·威廉姆森(CW)谢谢你今天邀请我. 今天我很高兴与大家分享关于人身伤害谈判服务的信息.
TK我们就从这个开始吧. 您能概述一下您使用的协商服务吗?
CW: 确定. Our provider negotiation services are really something we’ve been working with our first‑party coverages for years. So, 想想人身伤害保护(PIP)或医疗保险, 作为对这些保险的网络调整的补充. 但, 在过去的几年里, 我们已经把重点放在增加身体伤害(BI)索赔的供应商谈判上.
和 there are some unique differences that we 可以 talk about that are unique for bodily injury or auto liability, 一般责任索赔. 但 what we’ve put in place is a system to build on the relationships and knowledge we have of providers in the industry. 向他们伸出援手，确保对这些账单进行调整.
Adjustments are traditionally tough to get on bodily injury claims - adjusters do struggle to realize savings on those bills for a lot of reasons. We’ve really seen a lot of growth and interest in bodily injury and provider negotiations so have placed an emphasis on our program to develop some very specific procedures for bodily injury coverage. 我们帮你搞定理算员, 通知理算员, and provide an open channel of communication with us throughout the life of the negotiation so that adjuster feels and has control of timing, 因为我们都知道, 身体伤害索赔往往与PIP或医疗保险不同, 调整. 让我们的谈判代表接触到我们的人身伤害保险是我们关注的一个重要部分.
最后, we provide a final settlement agreed to by that provider and so there’s no risk of back billing or going back to the injured party or the third‑party claimant for additional monies or additional payment.
除此之外，我们还提供“抵押品来源”或事先付款信息. 我们看到的大约10%的账单最终都是提前付款的. This could be invaluable information for an adjuster to have even if we’re unsuccessful in negotiating with a specific provider. 知道供应商接受了一个特定的金额，就会有很大的不同, 尤其是在那些间接来源的州，比如德克萨斯州和加利福尼亚州. So, we’re really designed to help adjusters maximize savings in unrepresented bodily injury claims that 可以 be tough for adjusters to focus on.
TK: 伟大的, and you mentioned some of the unique challenges that third-party auto claims present - Can you talk about that?
CW: 当然,TK. There’s several things that we’ve learned along the way as far as expanding into third‑party coverages. 首先，我们与供应商在确保调整方面有着良好的基础关系. We find that providers are much more willing and eager to negotiate with us on those bodily injury claims because the payment cycle varies from first‑party coverages. 因此，这些供应商不一定会像第一方索赔那样向运营商收费.
所以, 在这些情况下, having the knowledge of prior payments that we 可以 return to that BI adjuster really helps them understand the true amount that they owe on each bill. 传统上，这可能是一个很难达到的数字. 和调节器, 不想升级索赔或试图进一步谈判节省, 会全额支付吗. These adjusters don’t realize that there’s that opportunity to seek out a prior payment or that amount 可以 be tough to get to for a BI adjuster with the payment process being less structured than PIP or MedPay. 为了方便使用，我们可以直接与索赔系统和支付系统集成.
So, 一旦我们确定支付金额或与供应商达成协议, we 可以 flow that rate through the claims system that a carrier is using and trigger a payment request in their traditional payment processes like we would use for first‑party or PIP.
One of the other things we’ve learned is that it is really important for a BI adjuster to have interaction and communication with our negotiators. We have made it much easier to communicate with our negotiations team upfront through a dedicated portal, 以及通过支持线向外伸出援手.
和, 最初是应他们的要求与我们协商账单, 我们提供特殊说明，如剩余政策, 或者在哪里谈判是有意义的, creating a much more collaborative interaction on the BI claim than it may be on a first‑party negotiation.
The final challenge I’ll talk about is fear of back billing or support that the adjuster’s will have in case that’s happened. We’ve developed a way to deliver signed settlements that that providers agree to full and final payment for the bill.
所有这些信息都可以通过我们的支持门户提供给调整人员, 我们可以按需提供这些已签署的协议，以确保账单支付, 索赔人不会看到这笔钱的结余账单.
因此，我们确保了这一点，并在此过程中提供支持. 再一次。, 一些独特的挑战很多过程都与我们在第一方所做的非常相似, 但有时这个过程有点不同, 我们还在流程和工作流程中制定了专门针对第三方索赔的程序. It’s a little different because adjusters are going to need a different level of support on those bills.
TK: 所以，调解员为什么不自己处理这些谈判呢?
CW: 你知道这是一个理算师的事情 可以 do, however; it’s very difficult for an adjuster or teams of adjusters to be consistently good at this. When you think about the core focus of an adjuster working with attorneys or directly with an injured party, 有时我们在实践中发现，这在他们的工作队列中被推到了后台. 这不是他们每天的首要任务, 尽管我们可以节省很多钱. Adjusters don’t necessarily have the process or the bandwidth to make sure that there’s a full and final signed settlement.
They don’t necessarily always have the expertise or the payment history with a specific provider or even know who to reach out to in that provider’s office. 我们在米切尔提供的许多服务将使其更有效率. You 可以 tap into that wealth of experience and relationships that we have with those providers and really allow the adjusters to put their focus back where their priorities tend to be, 哪一个是直接与受害方和潜在的他们的律师合作达成和解.
TK: 这些谈判有多成功，他们平均节省了多少钱?
CW: 因此，并不是每个供应商都会与我们协商亚博真人官方版APP. 在这些情况下, 如果事先付款, we’ll note that and return that to the adjuster so that they 可以 use that amount instead to secure an accurate payment on what they owe.
整体, we have a success rate of around 60 percent of the bills that are sent through us will result in savings. 然后 overall savings on bills that flow through us is 30 percent which are signifi可以t savings - and easy for the adjuster to wrap those bills to us.
我们也有直接集成的客户，他们只是通过我们的亚博真人官方版APP来支付这些账单, 如果事先付款，我们会给调整者一个基准利率. 然后, the negotiator will take those bills and negotiate them to the effect of 30 percent savings overall on the charges we see.