LTCG, a recognized leader in business process outsourcing for long term care insurance (LTCi), has announced the launch of its new Unified Provider Database (UPD). This new product contains detailed information for more than 100,000 senior care providers including non-skilled home care, skilled home health, assisted living communities, skilled nursing facilities, memory care, hospice agencies, adult day care facilities and continuing care retirement communities.
LTCG is the largest third-party claims payer in the LTCi industry, paying out just over $2 billion last year alone. The company initially built a database to capture key provider information for use in approving claims and to verify provider eligibility for policies it manages on behalf of its insurance company clients. After many years of using the system internally, LTCG recognized that all LTC carriers face the same provider data and eligibility challenges, so the company commercialized the database by building a secure portal and workflow tools to support access for external users. The UPD has already been licensed for use by three organizations in the LTCi space including Long Term Care Partners (LTCP), a third-party administrator responsible for managing the Federal Long Term Care Insurance Program.
The information contained in this database is used by claims professionals to locate the right care providers for policyholders and to verify that the provider is eligible to provide this care according to specific policy language. The Unified Provider Database improves the consistency and accuracy of these decisions while dramatically reducing the work involved in collecting and confirming valuable provider data. In fact, LTCGs customers have documented a 60-80% reduction in time spent on these administrative tasks.
Whether a claimant requests a specific care provider or asks for our recommendations, the UPD facilitates the determination of care provider eligibility under our policies, said Paul Forte, CEO of LTCP. The upshot is faster benefit payments, better claims decisions and an improved customer experience.
Each credentialed provider profile in the UPD contains more than 85 structured data attributes including the services provided, staffing model, scope of medication administration, licensed nursing care services, and many others. Insurers can download provider licenses, W-9s and professional liability insurance certificates through this tool. The database is also continuously updated and validated by LTCGs dedicated team to ensure maximum accuracy.
Our Unified Provider Database integrates well with our Provider Discount Program and CareExchange electronic visit verification (EVV) products, which are some of the many innovations that have been brought to market as LTCG invests in its claims management capabilities, according to Peter Goldstein, CEO of LTCG. The comprehensive, validated information in this database is critical to helping insurers manage rising claims costs, reduce risk and improve the efficiency of their claims process.
LTCG is the leading provider of administrative solutions and clinical services to the long term care and life insurance industries, with over two decades of experience in this space. LTCG currently manages over one million policies and serves more than 90 carriers nationwide. The company addresses all types of customer needs and policy requirementsfrom application processing and underwriting of new business to claims and administration of open and closed blocks. LTCGs advanced data analytics, actuarial and risk management capabilities and unmatched industry expertise can help organizations manage their business and develop emerging products such as hybrid life/long term care policies. LTCG also provides clients with unique risk management insights built upon the industrys largest database of long term care underwriting and claims outcomes and helps carriers bend the cost curve through innovative provider solutions and wellness programs. For more information, visit www.LTCG.com.