Millennium Risk Managers is a founding member of AlaMed, the largest preferred provider organization for workers compensation medical services in the State of Alabama.
AlaMed has preferred provider contract status with all of the major hospitals, surgical centers, outpatient diagnostic centers, orthopedists, neurosurgeons, gatekeepers, durable medical companies, case management companies, pharmaceutical companies and surveillance companies operating in the State of Alabama.
AlaMed’s reimbursement rates to these medical vendors and specialty service vendors are far below the Alabama state reimbursement medical fee schedule.
Unlike all the other TPA’s that have a medical cost containment contract with medical vendors, Millennium Risk Managers provides these discounted medical charges to our accounts at no charge or fee associated with the cost savings on medical bills.
The accounts that chose Millennium Risk Managers to handle their company’s claims administration can literally pay for the TPA services based upon the medical savings that are given to our accounts at no charge.
Millennium Risk Managers’ bill adjudication department is onsite at our company and therefore, the adjusters have immediate access to any questions or pre-certs concerning medical payments and our company’s long standing relationship with these major medical institutions insure our accounts quality medical treatment.
These contracts are statewide and encompass virtually every county in the State of Alabama and therefore, no matter where our accounts operate geographically within the State of Alabama, our accounts’ injured employees have access to the leading medical providers at these drastically reduced rates.
For further and expanded information on the AlaMed PPO and in depth background on the AlaMed service contracts, please go to www.alamed.net.
At Millennium Risk Managers we have taken the necessary steps to offer our clients the opportunity to provide their employees with the highest level of medical care for their injuries while at the same time ensuring that this care is provided at the lowest possible cost.
Millennium Risk Managers’ claim processing system is designed to have all lost time first report of injuries reviewed by the in-house attorney of Millennium Risk Managers before the adjuster receives the claims file. This process allows for expert review from a legal standpoint, at the initial stage of the claim. During this “initial screening” process, directives are given to the adjusters so that a proper “position” or “inquiry” is maintained from the outset. Likewise, this level of initial review assures the account that any directives given by the decision makers of the account are implemented from the beginning and throughout the process of the claims administration of a file.
As the law is currently written, the only right available to the employer in a workers compensation case is to choose the physicians, by whom the employees are treated for their injuries. We take full advantage of this right by encouraging our clients to implement a medical protocol. This simple document specifies not only the initial treating physician for any injury and specific emergency room for any after-hours injuries, but also designates potentially needed specialists (e.g. neurosurgeons and orthopedists).
Once our client selects their chosen doctors, a representative from Millennium Risk Managers meets with the initial treating physician and the emergency room to ensure that they will cooperate in implementing our clients’ desires as outlined by the protocol.
This protocol is important because it eliminates the following problems:
1. Medical treatment by an unauthorized doctor (stops an employee from going to his/her family physician and stops an authorized physician from making a referral to a specialist who is not approved by the account)
2. Unauthorized prescriptions (some employees will wait until the authorized treating physician’s office is closed and will then go to the emergency room where they will obtain another prescription for additional pain medication). This protocol only authorizes the emergency room to issue enough medication to get the employee to the next business day. The ER is instructed to refer the employee to the authorized primary treating physician to obtain a full prescription and to receive any needed follow-up care.
3. Unauthorized referral by the ER (stops the nighttime injured employee from going to the emergency room and then having the ER physician refer him/her to an unauthorized physician).
4. On numerous occasions, employees from the accounts will go to multiple emergency rooms in an attempt to bypass standard medical protocols. The standard response from such an employee is that no one informed them that they could not go to any emergency room of their choice. Correspondingly, we have developed and will implement an employee downline sheet (This employee downline sheet is suggested to be placed in all employment application packages) wherein the employee is informed of the authorized doctor and the authorized emergency room.
The medical protocol is very flexible. If at any time our client becomes dissatisfied with a chosen physician, simply another physician is chosen. Once the medical protocol is in place, we inform the employees of the location to report to for medical treatment if and when injured. The rest of the treatment process, including referrals, is already understood by all parties in advance. The medical protocol is extremely useful in late reporting situations. As a general rule, when the account is late in reporting the first report of injury to Millennium Risk Managers, we are not able to obtain correct medical management from the outset. The medical protocol assists in eliminating this problem because the employee is already being directed to the appropriate medical facilities and medical providers.
Millennium Risk Managers, in addition to the medical protocol, is a founding member of the largest workers compensation preferred provider organization in the State of Alabama. Our accounts enjoy the reduced medical costs obtained through the AlaMed PPO at no additional charge to our accounts. This feature saves huge dollars on the catastrophic claims and is an added/value feature of our services to our accounts.
COURTEOUS PROFESSIONALISM
We at MRM pride ourselves on working hand-in-hand with self-insured employers and group pools in administering their workers compensation program. We are adept at setting up customer specific requirements on how you want us to handle your claims, incorporate your rollover requirements of existing claims, and meet your excess carrier/re-insurance requirements. We assist our customers in establishing a medical protocol program consisting of management, emergency room, and employee procedures.