Olde South TPA

 

     The Third Party Administration division of Olde South Insurance Consulting Services is dedicated to providing quality service, accounting,  and cost-saving measures to its clients through effective proven methods of claim handling developed through years of experience.

  <                    Service

Olde South is unique in the face-to-face meeting and claims investigation on Workers= Compensation claims.  We make ourselves available 24 hours per day, 7 days per week.  We realize the first few hours of a serious claim can be the most crucial in preserving evidence and medical coordination.  Over the years of service, we have accumulated a data base of the best doctors throughout the state to handle the injured workers.  These Physicians have an understanding of the laws, goals, objectives and paperwork required in a Workers= Compensation claim.

• Our on-site claims investigation helps pinpoint causes and possible third party subrogation.

• Face-to-face claimant meetings help us explain what Workers= Compensation is and  how payments of benefits are determined.  It also builds a trust between the worker and his/her family and Olde South.

• Full caption reporting to our client within 14 days and every 60 days thereafter, until claim is closed/resolved to include current medical status, RTW goals and reserve review, keeps the client/employer up to date and informed.

  <               Accounting:

Olde South has designed and operates a complete claims administration WEB based system which allows its customers Internet access to claims files and all standard accounting needs for the Insurance Company.  This includes unlimited loss runs, up to date claims reserves, plus numerous other functions unique to this industry which is available to its clients 24/7.

          Cost:

Current contracts can be drawn on an hourly basis of $45 per hour or on a flat rate fee.  The average cost for a flat rate fee is $500 for lost time/controverted or $100 for a medical only claim.  Limited assignments or investigation is $45 per hour plus reimbursement of actual expenses.  As Olde South grows so will the claim volume which will therefore allow Olde South to realize an increase in profit per claim.        

                                                     COST CONTAINMENT

  Olde South has taken steps to secure discounts and other cost saving measures which will be passed along to its clients.

  <                     Olde South has contracted with Integrated Care Management (ICM) to conduct the following services on behalf of Olde South and their customers

•      EOB=s (explanation of benefits) at $.95 per line with a no line minimum

•      Access to automatic savings on a PPO.

•      $1,000 cap or 25% savings on all bill review.

•      30% savings off PPO cost

This fee was obtained from scrutinizing different service providers within this region.  ICM was able to provide the most capable and fastest service to enhance customer savings.  All workers comp payments to providers must be accompanied by an EOB.  Payment is due within 60 days of receipt or a 20% fine may be levied.  The Georgia 2000 Legislature has enacted new legislation reducing payment to 30 days.  ICM guarantees a 48 hour turn around on EOB=s by picking up bills and delivering EOB=s two times per week to and from our office.  Usual charges which are standard within the industry are $1.10 per line with a two line minimum and a 25% savings off bill review with no dollar cap.

 Through our partnership with MedNet, we have unlimited access to medical advice through their in-house medical director, David Hatmaker, M.D.  Dr. Hatmaker is a practicing physician and attorney which gives us a unique advantage in one-on-one dealings with other physicians on complicated issues.

  <                     On medical cases which require Independent Medical Examinations or chart reviews, Olde South has a 25% discount through MedNet on all case reviews not accessible to other TPA=s or carriers.  We also have a unique opportunity to discuss the review with the doctors prior to their final report.

  <                    Olde South has associated itself with Medical Services Corporation (MSC) of Jacksonville, Florida to provide prescriptions by mail as well as durable equipment.  This allows substantial discounts to the client for drugs and medical supplies.  MSC has initiated a new program with the use of prescription cards which allows claimants to purchase their medications at pharmacy=s and we still obtain the discount.

  <                     One Call Medical (OCM) is a national company which contracts for MRI=s, Cat-scans and other diagnostic procedures for rates substantially lower than the state fee schedule. 

  <                     With a thorough review and investigation of each claim a more precise dollar reserve can be placed on each claim for a better accounting expectation of the ultimate cost for clients.  This frees excessive reserves for market investment and better returns or allows clients to appropriately budget for ultimate cost of a claim.