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Auto Casualty Article

In-Network and Out-of-Network Trends

4 MIN READ

This analysis provides a comprehensive examination of prescription utilization across both in-network and out-of-network channels including retail pharmacies, mail-order services, and paper-based medical bill submissions. This dual-lens approach captures the full prescription landscape that extends beyond traditional pharmacy benefit management reporting, revealing critical cost and utilization patterns across all jurisdictions. While in-network channels demonstrate the real-time effectiveness of integrated clinical controls and cost management strategies, out-of-network data, often representing acute treatment episodes captured through medical bill review, exposes significant cost management opportunities and pricing anomalies. Together, these perspectives illuminate where pharmacy dollars are spent, how prescriptions are managed, and where targeted interventions can drive the greatest impact on both clinical outcomes and costs.

Workers' Comp Article

Key Trends in Workers' Compensation Networks

Discover the latest trends in Workers’ Compensation Networks with Kate Farley-Agee
Workers' Comp Podcast

Safe at Home: Managing the Provider Shortage in Home Health

Tune into this podcast where Nicole Usher delves into the effects of the provider shortage on home health care.
Workers' Comp Article

Specialty Solutions Spotlight: Optimal Levels of Service in Home Health Care

Asking the right questions is key to providing effective home health services for injured employees. Factors like medical complexity, physical constraints and mental needs are crucial in determining the appropriate level of service, impacting both recovery and financial outcomes.
Workers' Comp Article

5 Ways Enlyte is Helping Workers' Comp Providers

Discover the top 5 ways Enlyte aids Workers' Comp providers in our latest video featuring Kate Farley-Agee, VP of Network Product Management.
Auto Physical Damage Article

AI and Emerging Technology's Impact on Auto Claims

7 MIN READ

Auto insurers are facing unprecedented challenges this year as they try to balance the rising cost of claims with their commitment to making policyholders whole after a loss. In response, many are investing in artificial intelligence (AI) and other new technologies to both automate and accelerate the claims process.
Workers' Comp Article

Ask The Pharmacist: Topical vs. Systemic Pain Medication

Managing chronic pain with medications can be difficult for various reasons. Pain experiences and treatment effectiveness may differ among individuals and caregivers.

Workers' Comp White Paper

Healing at Home: A Holistic Guide to Workers' Compensation Recovery

1 MIN READ

 
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