After restructuring your existing workers’ compensation managed care program or implementing a new service provider, DonnCo performs ongoing audit and enforcement by identifying and correcting program underperformance, implementing improvements, and overseeing changes to program structure. Program enforcement includes ongoing program analysis and reporting that summarizes program trends, highlights areas of concern, and identifies the best options for program enhancement.

DonnCo typically enforces tasks such as: executing transitions between managed care service providers; enforcement of contract/performance terms; identification and correction of reporting errors; recapture of fee overcharges and overpayments to medical providers; calculation of performance-based fee incentives; early identification of program performance issues; and providing representation at client board and committee meetings and service provider negotiations. Through this process, DonnCo reduces its clients medical spend an average of $1.35 million a year beyond what they were saving.

Donnco fees are usually considered ALAE costs by its clients as we directly reduce paid medical at the claim level and in aggregate. This is done through reducing medical cost containment costs (bill review/PPO fees; UR and case management and PBM) and improving bill review service provider savings.