HM Insurance Group's nurses unify to deliver exceptional value to customers
WE ARE PROUD TO SHARE THESE 2016 STORIES:
Customers of HM Insurance Group companies are benefiting from an organizational change that brought together all of the company's registered nurses into one collaborative team in 2016. The registered nurses, who previously worked in two separate units Underwriting and Claims merged to create a strong force in case pricing and high-cost claims management.
At HM Insurance Group companies, nurses play a critical role in evaluating and pricing potential new business and case management oversight for current customers. In addition to scrutinizing data to contribute to the sales and underwriting process, the nurses analyze and interpret medical information in claims and evaluate the severity of medical conditions to assist in projecting costs and pricing cases.
Nurses also review clinical data to confirm network status and appropriateness of care to detect savings opportunities for HM Insurance Group companies' customers. In 2016, HM Insurance Group companies generated more than $15.5 million in savings through cost containment practices. These efforts included reviewing potential claimant notices for savings opportunities, pursuing third-party recovery situations, and adding competitive out-of-network discount programs and centers of excellence to maximize cost savings for catastrophic claims.
"By unifying our nurses and their medical expertise into a single team, we can deliver exceptional value to both internal and external customers by providing clear and concise clinical communications, from start to finish," said Dominic Palmieri, senior vice president, HM Insurance Group. "It also enables our nurses to more effectively and efficiently execute processes to meet customer and business needs today and in the future."