Outsourced Health Underwriting:
Large health insurance company, primarily focused on group but had individual portfolio to meet regulatory requirements. Plan used a small staff of medical underwriters, but had historically high turnover. When the manager left, the department lost its leadership and had no one to train new staff. The Carrier contacted Medwise Consulting Partners seeking a vendor who could seamlessly take over the operations.

Medwise Consulting Partners staff worked collaboratively with the carrier to assume all underwriting functions within a two week period. The Plan’s customer satisfaction increased along with the speed and accuracy of the underwriting decisions.

Pricing Assessment:
Board of a regional health plan asked Medwise staff to evaluate the plan’s large and small group premium rates. Medwise was able to do a focused analysis of the group’s business to determine that the plan’ s premium rates (and internal controls) were not adequate and likely to result in large underwriting losses.

Underwriting Assessment:
New CEO of a Regional health plan asked Medwise to do an assessment of the current underwriting processes and staff. Medwise review uncovered a variety of practices that were inconsistent with the company’s stated policies, did not adequately account for changes risk or medical cost and had the potential to become compliance issues as well. Medwise staff prepared a focused report, including a detailed action plan to correct the deficiencies.

Peak Underwriting Volume:
A regional health plan was faced with the combination of key staff vacancies along with a short term spike in monthly renewals. Medwise deployed two experienced underwriters on-site to assist the plan in managing through the increased volume.

Interim CFO Management:
Provider sponsored health plan was faced with the sudden departure of their CFO. On short notice, Medwise deployed an experienced health plan CFO to fill in while the plan conducted a thorough search for the replacement. The interim CFO was able to “hit the ground running” immediately helping with several key projects including an impending Medicare bid, reconciliation of premium billing and several large group renewals.

Interim Underwriting Management:
Medwise has numerous success stories where they have provided immediate (and in some cases, long term) interim management for a plan’s underwriting department. Every situation is different, but the common thread is the departure of the department head in a job market where the position is difficult to fill. Medwise team includes experienced underwriting managers who can walk in to a plan and immediately be functional with no learning curve. Medwise staff have helped rebuild departments, improve processes, train newer staff and support the sales team.

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