Medical Savings Program
Medical inflation puts a strain on everyone's bottom line. That's why PMAMC invests in
numerous programs to increase your cost-savings. We understand the link between escalating
medical costs, higher insurance rates and overall business costs-and how innovative
medical savings strategies can reduce the financial impact on your business.
Superior Disability Management - PMAMC's Disability Management Coordinators and Case
Managers are registered nurses, most with Certified Case Manager designations. Disability
and medical case management begins within 24 hours after injury notification. Our
three-tier disability management strategy includes telephonic case management, on-site
management for complex workers' compensation injuries, and for catastrophic case
management, we partner with a nationally recognized specialist.
Preferred Provider Network (PPN) - PMA Management Corp.
provides injured workers with access to a network of carefully
credentialed providers who offer quality medical care at preferred
rates. PMAMC's PPN includes a broad network of
hospitals and medical providers, so injured workers have many
providers from which to choose. We also offer our clients the option
of nominating new providers to our network..
Medical Bill Review - Our multi-step program is designed to realize savings by identifying
appropriate medical charges. PMAMC's Customer Service Center and medical bill repricing
software review all medical bills. Bills with more complex coding combinations and
clinical reports are reviewed by our Medical Cost Containment Team of Coding and Nursing
Professionals.
Out of Network Negotiation Program - Our Out of Network Negotiation Program targets costly
medical bills from providers that are outside of our Preferred Provider Network, often
generating additional savings below submitted charges, traditional state fee schedule
rates, or usual and customary charges on these bill types. Enhanced savings are achieved
on medical bills received for ambulatory surgical services, outpatient hospital services,
inpatient hospital services, durable medical equipment, emergency room treatment and
ambulance services.
Pharmacy Benefits Management Program - Our program helps to address rising prescription
drug costs by providing discounts on drugs at over 50,000 pharmacies nationwide. Injured
workers can access an array of pharmacies and incur no out-of-pocket costs.