Strategies to Control US Medical Costs: Medical Case Management and Bill Auditing

The cost of treating ill and injured crew members in the US far exceeds the expense of treatment in other regions of the world. This is because the US medical system has different regulations which allow the facilities and healthcare providers to provide services at varying costs throughout the country. To navigate the healthcare system and monitor cost of treatment, P&I Clubs often utilize medical case management companies to coordinate care and audit bills so Members can handle their next crew illness or injury claim in a more cost-effective manner.

Under international law and US general maritime law, all shipowners have a basic obligation to provide medical care on board ships and ashore to their crew members during illness and injury. This is a baseline obligation which crew contracts of employment and arbitration agreements expand upon, and which US law also expands upon for US crew members. For the purpose of this article, we are focusing on the baseline obligation to provide care. The efficient fulfillment of this obligation in the US is often challenging and can lead to unnecessary or excessive costs.

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Published by UK P&I Club.

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