ECU's Medical Solutions Program
Compliance with ECU's Medical Solutions Program is mandatory for both Traditional and EZ AGG™ Groups preferred pricing.
ECU requires that we be notified via email prior to payment on large claims as follows:
- > $10,000 on EZ AGG™ 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.
Claim 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
*Reports should be sent to Holly Baker hbaker@ecumgu.com and Monica Turner mturner@ecumgu.com
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
- Key Claims, Inc. newclaim@keyclaims.net for IN & OON claims negotiations
- Care Assist www.assistgroup.com for High Risk Pregnancy, Neonatal Case Management and Neonatal Hospital Bill Audits.
- Transplant Center of Excellence: CIGNA LifeSource www.cignalifesource.com, LifeTrac www.lifetrac.com
- American Medical Strategies (AMS) www.mdstrat.com, Nurse Audit www.nurseaudit.com, for hospital claim audits
- IHCA www.ihacrx.com, or Ethicare www.ethicareadvisors.com for Specialty Drug Program
- PNA www.pna-usa.com 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.
News & Events
- May 27, 2011
ECU Announces New Enhanced
EZ AGG™ - May 24, 2011
2012 ECU Producers Conference - March 1, 2011
ECU Celebrates 10th Year Anniversary - December 2010
Christmas party photos - November 10, 2010
ECU adds Gerber Life Insurance Company Paper - October 1, 2010
ECU Introduces Jeff Perkins as VP of Sales - January 1, 2010
ECU Announces Partnership with Niagara Re - May 12, 2008
Mike Hirsch Joins ECU as VP of Sales - January 1, 2007
ECU and Pan-American Announce New Small Group Aggregate Only Product - April 25, 2005
ECU adds Pan American Life Insurance Paper
Downloadable Forms
Forms and information packages available online - click here.
Spartanburg SC 29302
Phone: (864) 542-1565