A major reason 3rd party is different from 1st/PIP or WC is it involves tort, and the resolution of claims often lacks the speed and certainty of most contract coverages and fee schedules. Moreover, adjusters, attorneys and medical providers have competing interests, and the best negotiators have strong data and leverage. For these reasons, 3rd party cost containment is not a simple extension of PIP or WC competencies, and requires several "must have" competencies which also serve as a competitive advantage for Tempus: (1) We understand negligence and solve for how ambiguity impacts process. It's more complicated than reducing a medical bill, because attorneys reject offers and adjusters need to consider general damages, limits and LAE when addressing medical specials inflation. Our solutions, process and service are designed for these "real world" dependencies. (2) We know the state laws and regulations. We know where our solutions work best, and knowing the state environment enables us to create new solutions at a single state and national level, which supports our client base of national and regional carriers. When we ask for feedback (user inspired innovation) it is to create and improve, not to learn the business from you. (3) We have experience working in claims litigation and negotiations. It's easier to innovate and serve if you've actually done the job. We have deep SME in claims, provider negotiations and attorney/claimant negotiations including both special and general damages. That doesn't mean we have all of the answers, but we do ask good questions.
For Tempus, these competencies are the price of admission. The next step was defining our differentiation areas: unique solutions and superb execution.
Competitive advantage is doing different activities than your competitors and capturing value from them. We built TempusDirect by creating one unique solution after the next, with different activities within each of them. No one else has the “what we do” or “how we do it” inside of Claims Validation or Live Benchmarks, and we leverage the symbiotic relationship of our solutions to create new ones with shared data and best practices. This user inspired innovation model is fueled by our passion for the business, or the “why we do it,” which is also a competitive advantage.
Operational excellence is doing the same activities as your competitors but executing better on those same activities. 3rd party claims adjusters deal with unique negotiation scenarios every day, and they should have quick access to a highly skilled service organization that knows 3rd party and can provide support. We excel at service with our team of “claims smart” associates who partner with adjusters to identify errors, fraud, or customize our approach to the special circumstances of a claim. Importantly, we build strong relationships with every provider and adjuster using our solutions, which is key to a sustainable 3rd party model.
Finally, with unique solutions and excellent service, we aspired to make our scalable solutions easily accessible by adjusters. We’re launching our adjuster centric portal in October and recently announced our Guidewire partnership which allows us to deliver our solutions via ClaimCenter. These are important strategic initiatives for us as workflow and process will be critical as we continue to deliver new solutions.
Thanks to everyone for your support. We'd love to hear your feedback and ideas, so please reach out to me and follow us on Linked In.