Attorney Perspective
What are some best practices, expectations, and solutions for daily challenges involving working relationships with third-party administrators?
Building relationships with your third-party administrators and employers is critical to the ultimate outcome of your cases to ensure successful resolution. Open communication and shared information across the board allows for collaboration and effective litigation strategies. Many challenges arise for attorneys with the recent trend of high turnover involving adjusters and their respective case count.
Client Perspective
What are some overall problems amongst all of the third-party administrators and what is causing employers to bring their business elsewhere?
Employers are changing third-party administrators in an effort to better build their TPA relationship and this may involve utilizing dedicated adjusters, however, an overall issue is when your adjuster may not have the level of expertise in all of the states where your business is located. Setting forth clear and concise expectations and audit requirements at the outset of the contract may alleviate such issues. Strategic initiatives should also be considered along with best practices. Changing third-party administrators can be costly and time consuming with many of its own challenges. Retaining relationships with a panel of attorneys is also key to the successful outcome of cases.
An entirely different challenge being experienced is when an employer is unable to change third-party administrators. Under such circumstances, it is even more critical to foster ongoing relationships and set expectations to avoid errors and issues from the past.
Utilizing a broker in relationships with third-party administrators can bridge gaps in communication and avoid turnover and excessive claim costs. Using brokers can also be a critical part of negotiating any contract including those involving managed care costs in an effort to best maintain the financial landscape of a company.