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Pointing plan members to providers they can trust

Positive results for plan members and their employers. A year ago, plan members in the London, Ontario area were introduced to Manulife’s Trusted Provider Network. The pilot program was created to improve plan members’ experiences in sourcing the medical supplies they need. Each trusted provider in the network was screened and confirmed to deliver a high-level of professionalism and ethical service to their customers.

Easier process with fewer complaints and lower risk

Plan members using the Trusted Provider Network get their medical supplies without needing a pre-payment audit. It’s a more efficient claims experience for members, and the number of plan members using one of the trusted and reputable providers in the network has gone up. There’s also been a decrease in members using providers who haven’t been through the screening and auditing needed to join the Trusted Provider Network.

In the past, some dishonest providers offered incentives that encouraged plan members to claim for supplies when there wasn’t a true medical need. The Trusted Provider Network helps remove that risk, resulting in fewer false claims. In the 12 months since the pilot started, participating groups have seen fewer inquiries and interventions when claims are made through the network. For example, one group’s claims for orthotics and elastic stockings reduced by 49%*. This is a strong sign that plan members are using the network, and only claims based on a genuine medical need are being submitted to the plan.

Expanding the pilot

Based on the success of the program, more plan sponsors wanted to join the pilot. Working with these groups, the Trusted Provider Network was expanded to the Hamilton and Niagara regions.

The success of the program to date tells us plan members, plan sponsors, and participating providers value the approach and support the initiative. Building the network will take time, but Manulife welcomes the chance to work with our clients to gradually expand to new markets. It’s a pro-active effort to improve plan members’ experiences while taking concrete steps to protect the plan sponsor’s interests and investment.

*Source: Manulife Group Benefits

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