Quality and Compliance, Built in from the Beginning

Introduction

UR Partner’s operating model puts quality and compliance at the forefront of everything we do. Simply complying with statutes and regulations is not enough. Cost containment should not be transactional in nature. Our approach fosters a positive experience. This results in adding value to the service thereby securing better outcomes for all stakeholders.

As many of us know, Workers’ Compensation was forged by the “Grand Bargain.” Employers committed to providing those injured on the job with lost-time and medical benefits on a no-fault basis while the employee gave up any other legal remedy.

By nature, people do not prefer to be forced to do anything. When we do not have a choice, we tend to find problems with the solution presented. This cannot be further from the truth with delivering workers’ compensation benefits. Over the last 100 years, states have addressed this concern by instituting compliance requirements on those providing benefits. Compliance has become a critical component in our benefits delivery system.

Designed to Provide Better Outcomes

UR Partner’s cloud-first model enables the flexibility, responsiveness, and scalability to meet the needs of today and the future. Our greenfield approach minimized the time and effort to achieve our URAC ac

creditation. For those that are not intimately familiar with URAC, one of their standards focuses on consumer protection and empowerment. We see the claims administrator and employer as our consumer. Many states impose steep sanctions for non-compliance with Utilization Review. We see ourselves as an extension of the claims administration process, ensuring our customers clearly understand how we aid them in achieving compliance.

However, compliance is just one ingredient in delivering a best-in-class service. Providing a quality outcome that

delivers value is equally as important. Quality is derived from how one provider differs when measured against another. UR Partner has leveraged technology to improve the caliber of this offering to our industry. Those administering claims have a lot on their plate. Being a customer-centric organization, we challenged our team to develop a very low touch process. Our platform has elevated the ease of completing Utilization Review.

Conveying expectations to the injured employee is paramount. Our approach does not stop with the claims administrator and physician. We understand those injured on the job may not understand why the care requested by their physician is being questioned. In states that have medical control, this is further exacerbated by the fact the care requested is from an employer controlled/directed physician. When care, requested by their physician, is denied it creates an awkward dynamic that can lead to the injured worker feeling disenfranchised and seeking an outside resource. Litigation increases the cost and duration of workers’ compensation claims exponentially. We shepherd the injured individual through this process, by emphasizing expediency and necessity. If care is denied, is not to save the carrier or employer money, it is by virtue to avoid unnecessary and possibly harmful medical care.

Conclusion

UR Partner was established to provide a compliant, low touch process that adds quality and value for all stakeholders. URAC accrediting UR Partner is a testament to our ongoing commitment to those impacted by UR decisions. In some instances, processes that are required repeatedly can become perfunctory. We are passionate about utilizing each decision as an opportunity to communicate the “what” and “why” to promote understanding and acceptance. Please contact our team today to learn more.