Medical Cost Management

With medical inflation increasing at double digit rates and workers' compensation costs escalating more rapidly than general health care, United Heartland has developed an aggressive cost-management strategy. This strategy includes: medical case management; physician advisor reviews; preferred provider organizations (PPOs); prescription drug benefits; usual and customary fee reimbursement levels (UCR); and medical bill audits.

Our approach to medical case management focuses on the care an individual receives to ensure it’s appropriate and maximizes healing. UCR/fee reductions effectively reduce medical costs to our insureds, and medical bill audit ensures that the charges billed are appropriate and injury-related.

Our PPO arrangements offer employers discounted fees for the medical services provided to an injured worker. The savings realized through utilization of the PPO network (based on billed dollars alone) is more than 40 percent. PPO arrangements establish open lines of communication with treating providers in order to monitor the medical progress of claimants. These lines of communication play an essential role when working jointly with the insured and provider to make maximum use of a modified duty business practice. The effective use of modified duty is second only to the prevention of injuries in terms of reducing the cost of workers' compensation insurance and is absolutely critical to our process. As such, we will not insure a business that won’t make a commitment to this important practice.