Medical Cost Containment
Sentry provides medical cost-containment solutions that significantly reduce the costs associated with workers' compensation claims. Based on National Council on Compensation Insurance, Inc. data, medical costs represent 59 percent of all workers' compensation losses. According to the Insurance Information Institute, this number is projected to increase to as high as 70 percent by 2016. The fee structure of a cost-containment program has a major impact on overall workers' compensation costs.
Sentry administers its programs with no added fees or mark-ups. Fees billed to our customers represent only those charged by vendors. Unlike many of our competitors, Sentry's cost-containment program is not a separate or hidden profit center.
Bill Review
Sentry's extensive bill review process begins when bills are received by our Medical Cost Containment Unit. Each bill is reviewed to ensure it is related to a specific claim, confirm compensability and eliminate duplicates. Once a bill is determined to be compensable, it is entered into our state-of-the-art claims system.
We charge a flat rate per bill - other carriers and TPAs charge per line item or a percentage of savings, resulting in an increased cost.
Preferred Provider Organization (PPO)
After the bill review process, PPO-contracted discounts are applied for additional cost-savings opportunities.
By using Sentry's PPO, our customers can:
- Utilize more than 535,000 outpatient providers and 6,000 hospitals
- Access online tools to create worksite posters listing medical directories and participating providers
- Control loss costs and maximize the value of medical treatments
Sentry has negotiated a superior PPO charge resulting in significant savings relative to our competitors.
Our approach has the potential to provide significant savings that most of our competitors simply cannot match. Sentry's customers receive bill review and PPO savings of more than 40 percent of the original amount billed.
Pharmacy Management Program
Sentry has a comprehensive program for managing the cost of prescription medicines for injured workers. The program applies extensive clinical expertise along with workflow-driven technology to increase efficiency and reduce the total cost of prescription drugs while raising the quality of care for injured workers.
