Medical Cost Management

Workers' compensation costs have been escalating more rapidly than costs associated with general health care. United Heartland's aggressive cost-management strategies have been effective in containing these escalating costs. These strategies include: medical case management; preferred provider organizations (PPOs); usual and customary fee reimbursement levels (UCR); and medical bill audits.

Each of these elements works in its own way to impact the cost of the medical care that an employee is receiving. Our sports medicine approach to medical case management focuses on the care an individual is receiving to make sure that it is appropriate and is designed to maximize the healing to prevent recidivism. UCR/fee reductions are an effective means of reducing medical costs to our insureds. Medical bill audit ensures that the charges billed are appropriate and injury-related. And our PPO arrangements include discounted fees for medical services provided.

We work closely with our PPO providers to ensure that our claimants receive appropriate and cost-effective care. The focus of our PPO arrangements is not only to obtain a discounted fee schedule, but also to establish open lines of communication with the treating provider in order to monitor the medical progress of our claimants. These lines of communication are essential when working jointly with the insured and provider to make maximum use of a modified duty business practice. It is our philosophical contention that the effective use of modified duty is second only to the prevention of injuries in terms of reducing the cost of workers compensation insurance. The use of modified duty is absolutely critical to the entire United Heartland process and as such, we do not insure businesses that will not make a commitment to working with us in this important business practice.

The savings realized through utilization of the United Heartland PPO network - based on billed dollars alone - is now in excess of 20%. We are building on that success by expanding our network of preferred providers.

Look at our results which are based on billed dollars