SCU Transplant Savings
Success Story

To assist in managing your clients’ high dollar claims, Tokio Marine HCC – Stop Loss Group’s (TMHCC’s) nurses and experienced staff in the Specialty Claims Unit (SCU) collaborate with payors, utilization review firms, and Large Case Management organizations to ensure early case intervention for these types of claims.

The following success story demonstrates one way in which Tokio Marine HCC – Stop Loss Group's SCU has helped with high dollar transplant claims.

A 42-year-old man with stage IV kidney disease was referred for a kidney transplant. TMHCC received a request from the third-party administrator to review the vendor contracts and provide the best potential for cost savings. TMHCC’s Specialty Claims Nurse reviewed the contracts and determined Emerging Therapy Solutions® (ETS) would offer the best contracted terms. A signed agreement was obtained between ETS and the policyholder, resulting in a savings of 71%.

Contact your Regional Marketing Representative to learn how our Specialty Claims Unit can assist you in managing your clients’ high dollar claims.