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Real Questions
4
Employers

  • Employers: Putting employees first to do the right thing for the patient

  1. Why is your workers comp carrier still have no auto-adjudication process in place?

  2. Why is the TPA still reading every clinical note using 20th century manual processes?

  3. Why are you still getting calls from employees why their appropriate care is denied?

  4. Why are you still getting calls from employees that your TPA is practicing medicine?

  5. Why are you still allowing the TPA to use denial of appropriate care as a success metric?

  6. Why is the TPA still using metrics of denial of care & not “right-sided” appropriate care?

  7. Why are you still having difficulty instituting reasonable site of service criteria?

  8. Why is the TPA still using “AI” that is a one-way conversation (dumb “smart forms”)?

  9. Why is the TPA not using real time cognitive feedback for UM? (Israel Patent 251953)?

  10. Why is the TPA talking e-prior authorization that does not contain clinical elements?

  11. Why is the TPA not using automated cognitive audit tools for coding/medical necessity?

  12. Why are you still having difficulty understanding drug pricing transparency for your PBM?

  13. Why is your money still setting on the TPAs balance sheet and not on your own?

How did you get here?

Don't Ask...

But you are here... fix it!

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