Address industry challenges of pharmacy spend, network penetration, costs, compliance and service quality with clinical expertise and analytical tools.
Auto No-Fault
Customized for managing auto no-fault claims, our comprehensive solutions provide a high-quality network for injured parties and clinical expertise with advanced analytics for case managers.
All of this enables you to make better decisions throughout the life of the claim so you can deliver high-quality experiences to your policyholders.
Beginning with the first fill, you'll be able to:
- Capture prescriptions and services in-network
- Track and manage available no-fault benefits
- Enable hassle-free transactions with no out-of-pocket expenses
- Provide vetted quality ancillary services
- Achieve better outcomes with timely clinical insights
For injured parties, this means fewer hassles, lower costs and a better overall claim experience. For you, it means less administration, an improved bottom line and satisfied policyholders.
We provide a dedicated implementation team to make your transition to Optum easy and seamless. Our team ensures that all critical pathways are identified, documented and integrated before launch, so your program runs accurately and efficiently, right from the start.
Designed specifically for auto no-fault claim management our services include:
Pharmacy Care Services
- In-network prescription management
- Robust, nationwide network that includes nearly all of the nation's pharmacies
- Electronic capture of all transactions
- 24/7/365 customer service
Medical Services
Provide access to quality care through a broad PPO network while managing clinical outcomes with case management services.
- Physical medicine
- Medical bill review
- Case management
Ancillary Services
Ensure quality care with vetted providers for discharge planning, transportation, language services, medical equipment and home care.
- Diagnostic testing
- Durable medical equipment and supplies
- Home health care
- Language services
- Transportation services
New Jersey Auto Pre-certification
Our auto injury management service (AIMS) adheres to the New Jersey Automobile Insurance Cost Reduction Act of 1998 (AICRA). Our AIMS professionals are experts in auto injury claims management and they manage the entire pre-certification process including appeals and dispute resolution.
Covering all aspects of a claim from pharmacy, to ancillary, to medical, our program is designed as a turn-key solution for auto carriers in adherence of AICRA regulations.
Contact us to learn more about our NJ Auto Pre-Certification program.
NJ Auto Pre-certification PDFs
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