ECU's Medical Solutions Program
Compliance with ECU's Medical Solutions Program is mandatory for both Traditional and Spaggregate Groups preferred pricing.
ECU requires that we be notified via email prior to payment on large claims as follows:
- > $10,000 on Spaggregate groups
- 50% of the Specific deductible on traditional groups.
- The following information must be provided prior to payment of the claim:
- The In Network discount amount*
- The Out of Network discount amount*
- A copy of the UB-92
*ECU reserves the right to try to obtain a better discount if the discount presented is less than what is considered Reasonable.
This information should be emailed to: Maureen Wilkie mwilkie@ecumgu.com and Donna Duncan dduncan@ecumgu.com
Notification requirements:
1: When a claimant reaches 50% of the Specific Deductible (or $10,000 for Spaggregate groups) or has a trigger dx (See ECU's Claim notices & Filing Procedures for the trigger dx list) we require:
- Weekly Precert reports
- Monthly Large Case Management reports
Agree to use ECU's preferred vendors:
- Global Excel Management www.globalexcel.com for negotiations on Out of Network claims or In network hospital claims over $25,000 with discounts of 15% or less
- Care Assist www.assistgroup.com for High Risk Pregnancy, Neonatal Case Management and Neonatal Hospital Bill Audits.
- Transplant Center of Excellence: CIGNALifeSource, LifeTrac www.lifetrac.com or Interlink www.interlink.com
- American Medical Strategies (AMS) www.mdstrat.com, Nurse Audit www.nurseaudit.com, for hospital claim audit's
- Ethicare www.ethicareadvisors.com for Specialty Drug Program
- Golden Triangle Specialty Dialysis Network for dialysis discounts.
(Please note preferred vendors of the TPA may be substituted for ECU's preferred vendors with approval from ECU. ECU will also provide plan language for the proposed SPD amendments, when requested.)
For Additional Information or Questions Please call or email Maureen Wilkie at 864-542-1590 mwilkie@ecumgu.com or Donna Duncan at 864-542-1523 dduncan@ecumgu.com.
- January 1, 2010
East Coast Underwriters Announces Partnership with Niagara Re - July 1, 2008
ECU adds Starr Global Accident & Health Insurance Agency, LLC - May 12, 2008
Mike Hirsch Joins ECU as VP of Sales - January 1, 2007
ECU and Pan-American Announce New “Spaggregate™” Product - October 31, 2006
Halloween party photo gallery - April 25, 2005
ECU adds Pan American Paper
Downloadable Forms
Forms and information packages available online - click here.
Spartanburg SC 29306
Phone: (864) 542-1565