Amerisys
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Preferred Providers

It is estimated that 25-30% of medical expenses are made up of ancillary services. It is imperative to have exemplary ancillary service providers as this is likely to impact not only the economics of a file, but overall satisfaction of injured employees and customers as well. Due to this potentially exorbitant impact, AmeriSys separates ancillary services from the physician networks.

Every three years AmeriSys publishes a comprehensive RFP for diagnostics, DME, home health, physical therapy, transportation as well as translation services. A selection committee is engaged, involving AmeriSys staff as well as customer representation, to review the responses, select organizations for oral presentations and then make recommendations for engagement of contract negotiation. Resultantly, we continue to provide industry-leading providers that have committed themselves as partners with AmeriSys to assure high quality care services on behalf of the injured employees we serve at competitive pricing.

At AmeriSys we recognize the importance of going beyond cost reporting, thus our commitment is clinical as well as economic. We track performance standards and require extensive detail reported on an individual claim basis from all ancillary services. AmeriSys ancillary service providers are contractually obligated to supply performance reporting on each referral on a monthly basis. This unique reporting goes above the typical cost outcomes approach and provides analytics to a detail level including tracking of mileage, contact attempts, arrival times, wait times and benchmarks, as well as a myriad of other outcomes. Tracking these detail analytics provides recognition of trends, positive or negative, and allows early intervention where appropriate.

Pharmacy

We are very pleased to offer a pharmacy benefit management component to our services. Our PBM offers a pharmacy card for the injured employee that provides quick and easy access to the majority of all the major pharmacy outlets and major chains. This benefit seems to improve employee satisfaction. This program also improves the overall control, management and administrative efficiency of delivering prescribed medications resultant of their work-related claims. A second component of the pharmacy discounted savings is that we capture not only savings on the pharmacy bills on-line directly from the pharmacy but also on paper claims that are submitted outside of the electronic standard billing.