Medical Risk Managers
Private Label Services
We will work tirelessly to protect and promote your brand and help you achieve your targets while seamlessly operating as your silent partner.
MRM has underwritten on behalf of regional health plans and other direct carriers for 35 years. Our partnerships are strong and long-term because of the value we bring to our customers. Regional health plans have trusted MRM to underwrite on their behalf as well as provide guidance on reinsurance structure and pricing. We also bring a broader view of the market whether its reinsurance issues, geographical reimbursement differences, or product based changes needed to effectively compete. More recently, provider owned plans are seeking advice from us on how to handle risk-sharing in the self-funded space. We can scale our services to meet your needs. See all the ways the MRM can help you below.
Rating
Our front line team will scrub the opportunity. They will evaluate the census for completeness and verify that the proper network has been identified. They will also ensure the submitted reporting is sufficient to develop an experience rate. Our rating team has quality and performance targets which means your opportunity moves quickly through the queue and onto an underwriter’s desk.
Underwriting & Clinical
At MRM we pride ourselves with the knowledge and expertise developed in our Underwriting and Clinical teams. Both teams share a tremendous amount of experience in the Stop Loss Industry, averaging 23.5 years of service in underwriting, and 26 years of service as clinicians.
MRM truly focuses on Customer needs. Our underwriting expertise enables us to work closely with each client to accomplish all their goals, from meeting Sales targets, to achieving bottom line results relevant to favorable Loss Ratio expectations. Each of our underwriters look for the best solutions, even working outside the box to come up with creative alternatives to meet a desired result.
Our Clinical staff is an extension of our underwriting team. They not only understand treatment expenses, but they also understand stop loss contracts and how catastrophic claims could span more than one deductible. Our nurses work tirelessly to effectively manage claim costs, ensuring all treatment options and cost savings are on the table and negotiated. They care for our clients as if they were their own patients, and are driven knowing they can make a difference in each outcome. Our staff is well versed in the latest treatment trends and new drugs on the market. They will be able to give current assessment of all treatments, so our customers will not be blindsided by the extreme costs associated with those treatments.
Check out our quarterly clinical newsletters here
Actuarial / Pricing
Target rate increases, laser studies, portfolio analysis, discount analysis and stop loss liability development. These are just some of the ways our actuaries can add value to your actuarial team. MRM has an in-house Actuarial department that develops and maintains our proprietary Stop Loss pricing model. We perform frequent claim studies as well as benchmarking against national consulting resources to ensure the accuracy of all risk factors used in the manual algorithm. Actuarial also works hand in hand with Underwriting to develop procedures for effective blending of manual risk with individualized group experience.
Policy Issuance
Quality Control and a rapid Turnaround Time are two key elements required for a successful policy issuance. At MRM, we provide both. Policies are issued within five business days after receiving the signed Application, the first month’s premium and required licenses. MRM ensures that the policy is accurate and reflects exactly what was purchased.
What our customers are saying:
“Special thanks for doing this so quickly. I wanted to impress this broker and you did.”
“Just wanted you to know your issuing team has been doing a great job getting me the final documents. Thank you for staying on top of this process, I appreciate it.”
"We all enjoy our working relationship with everyone at MRM, and hope to grow more business together.”
Financial Accounting
Committed to the integrity of the financial reporting process and fiduciary responsibilities, our experienced staff is focused on offering continuous quality service within the unique accounting requirements of our Insurance Carriers, Policyholders, Reinsurers, and Brokers. Whether providing guidance through the claim reimbursement process, producing monthly statement bordereaux reports, or ensuring timely payments to our partners, MRM is committed to an accurate, streamlined financial experience.
Claim Adjudication
We are your front line when it comes to paying claims. Health plans, reinsurers, and direct carriers look to MRM for guidance and assurance that claims are appropriately reimbursed. Close monitoring of employer plan documents as well as carrier and reinsurer terms and exclusions are just the start. Today, MRM’s claim team spends much of its time working with innovative cost containment solutions that keep expenses down for both employers and carriers. Making the employer whole – quickly and accurately are our main goals.
Producer Licensing Validation
We facilitate the gathering of licenses and paperwork needed for carrier appointments and commission payments, and have been doing this for decades. Our detailed database tracks contact information, state specific license numbers and expiration dates. We also have access to a national producer database to research producer information and can help with state licensing regulations.
Reporting
MRM has incorporated 35 years of Underwriting, Premium Accounting and Actuarial knowledge into a comprehensive administration system. We understand the variety of reports needed to track Stop Loss. From our stock reports (new business opportunities, active case listings, persistency, claim reports, premium bordereaux and incurred loss ratio reports) to ad hoc report requests that allow you to slice and dice your data in a variety of ways, we match our clients' reporting needs with professional solutions.
