MANAGED CARE SERVICES

Since one of the components within numerous Automobile and Worker’s Comp. Insurance Program is the adjusting and administration of Personal Injury Protection (PIP) claims and Medical Payment claims, certain other Medical Management vendors may be necessary. Many states utilize a "fee schedule" of some type that establishes certain cost guidelines. These guidelines cover each medical modality, establishing maximum billing allowances and establishing time frames within which service providers must notify the insurance company of their utilization.

Independent Fee Auditing is quite cost effective and very quickly pays for itself based on the substantial deductions that are often possible as a result of the use of their extensive database, Preferred Provide Organizations and other resources. The recommended Managed Care Service Providers also handle the coordination of Independent Medical Examinations which are sometimes necessary in the efficient and cost effective adjusting of both Worker’s Comp and Automobile PIP claims.

To facilitate the above necessities and based on our volume of business, VANGUARD CLAIMS ADMINISTRATION, INC. has negotiated extremely favorable rates with most of the major Managed Care Service Providers. These savings are passed long to our clients whenever possible. Our rigorous review process ensures that only the highest level of service will be maintained on our client’s behalf. We have found our vendors demonstrate outstanding performance and value on behalf of both VANGUARD and our clients. Certainly the choice of a Managed Care Service Provider is ultimately the client’s, but we at VANGUARD CLAIMS ADMINISTRATION, INC. stand ready to bring our experience to play even at the early planning stages.