Working With Third-Party Administrators Helps Control Claims

Third-Party Administrator (TPA) adjusters form the front line of defense against unnecessary claims expenses, including such traditional cost drivers as fraud or opioid pain medication addiction. They’re the ones who determine how soon employees will mend and return to the job, the length of claims, and whether closing a claim will require additional resources, such as attorney involvement. It makes sense that the more closely you monitor the adjusters of your company’s TPA, the lower your Workers Comp claims costs – and premiums.

However, adjusters today are running on overload more than ever. In addition to managing larger caseloads, they face growing real-time information demands, increasing communication speed, and expanding regulations – which distract them from such cost-control practices as staying in contact with injured workers. Says one claims adjustment expert, “The fastest way of getting an injured employee to hire an attorney is making them feel like you don’t really care about their injury. So you end up with a lot more claims than necessary going to attorneys, which leads to higher claim costs.”

It makes sense to work closely with your TPA adjuster by following these guidelines:

1. Interview adjusters before they’re assigned to your company.
2. Review the adjuster’s claims notes on a regular basis.
3. Audit the TPA’s services periodically to make sure that the adjuster is meeting your expectations.
4. Develop close relationships with claims examiners and their supervisors.

We’d be happy to work with you and your TPA adjuster on keeping tabs on your Workers Comp claims costs. Please feel free to get in touch with us.