Curbing Costs in Bodily Injury Claims

1/5/2015 in Blog Categories, News

Christopher Tidball has a good piece at propertycasualty360.com on strategies to curb the rising cost of bodily injury claims.  As Tidball notes, bodily injury claims continue to rise at rates faster than inflation.  He focuses on taking proactive steps on the front end of claims to ensure that a complete investigation is performed so that damages do not get out of hand without the claims professional’s awareness.  A few suggestions are particularly useful as these investigation techniques sometimes fall under the radar:

  • Was the claimant indexed? Are there any hints of prior claims?
  • Was a background check run to identify marriages, known associates, criminal history, professional licensure and assets completed?
  • Were state licensure databases checked for the treating medical providers and attorney?

Perhaps the most useful suggestion is to pay exceptionally close attention to the actual medical bills.  Specifically, Tidball notes that coding is frequently used to increase reimbursement.  In a telling example of how coding can be manipulated to drive up costs,

Consider a basic lumber MRI with and without contrast. A provider may bill 72148 and 72149, which would be appropriate for these as individual diagnostic tests. However, when they are conducted together, the appropriate code should be 72158, which is the bundled code [and will result in a lower overall bill].  (Parenthetical and emphasis added).

In addition, Tidball reports that using fee schedules or benchmarks to evaluation medical bills will help to contain costs and keep bodily injury expenses reasonable and under control.   

The article is short, but provides some useful strategies for controlling costs in bodily injury claims.  As is the case with most claims management, the key is to get in front of the claim from the beginning.  Conducting thorough background checks on all parties involved and carefully examining billing codes and reimbursement rates are some strategies that will help claims professionals get in front and stay in front.  

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