East Coast Underwriters Medical Solutions Program
Notification Requirements:

Compliance with ECU’s Medical Solutions Program is mandatory for both Traditional, EZ Funding and EZ AGG™ Groups preferred pricing.

ECU requires that we be notified via Email prior to payment on large claims as follows:

The following information must be provided prior to payment of the claim:

*ECU reserves the right to try to obtain a better discount if the discount presented is less than what is considered Reasonable.

When a claimant reaches 50% of the Specific Deductible ($10,000 for EZ AGG groups) or has a Trigger Dx, we require (See ECU’s Claim notices & Filing Procedures for the trigger Dx list):

ECU Preferred Vendors


IN & OON Claims Negotiations


Advanced Risk Managers
The Phia Group
Penfield Care Management


www.adcanrm.com
www.phiagroup.com
www.penfieldcare.com



Dialysis Re-Pricing and Negotiation


HCControl


www.hccontrol.com




Transplant Center of Excellence


Cigna LifeSource
Life Trac
Interlink
6 Degrees Health


www.cignalifesource.com
www.lifetrac.com
www.interlinkhealth.com
www.6degreeshealth.com



Hospital Claim Audits


American Medical Strategies (AMS)


www.mdstrat.com



Specialty Drug Program


Ethicare


www.ethicareadvisors.com



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.)