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Workers Compensation Program Medical Network Critical To Not Harm


Workers Compensation Program Medical Networks Critical

Does your company have a solid Workers Compensation program?   This would apply to all employers regardless of size, type of insurance program, or state. California has shown that MPNs (Medical Provider Networks) are a way to reduce premiums very quickly. Designing your provider network is a task that will pay your company back with a large amount of savings.

Vector Graphic Of Physicians Workers Compensation Program And Hospital

Does your company’s Workers Compensation program have a medical network in place? If not, you are very likely spending 400% more on your premiums. I performed a study ten and again two years ago on a set of public entity files that indicated that very fact. The 400% is a conservative figure. How do you set up a network of doctors and other medical providers for your company? The first step is to take some type of action.

  • The first step is always the most difficult. Your medical bill processing company – which is sometimes your insurance carrier – has a list of doctors in their network. You can usually save about 15% on your medical bills just by using these medical providers. Find the ones in your area and direct your employees to use them.
  • Find the doctors that are industrial-minded inside of the network. This is a double saving as your company gets the network discount from your carrier/TPA. Your company will also save as industrial-minded doctors and providers tend to return the injured employees to work earlier.
  • Vector Of Stethoscope And Dollars Workers Compensation Program Graphic

    If you do not like the providers that are in your carrier’s/TPA’s medical network, then explore your local area for industrial clinics. We have seen great results from Concentra Medical Centers. Certain state laws may prevent you from going outside of your medical network such as the MPNs in California. We have found that medical walk-in clinics are great for minor injuries.

  • Once your network is in place, communicate with the medical providers. I will cover the communication to the medical providers in the next one or two posts. This relates to my last post on return to work.
  • Monitor the network for changes in medical providers. Quite a few of the pharmaceutical networks have changed over the last few years. The network that you originally built may not be the same even after one year.
  • Communicate the network to your employees. We have advised companies to place the medical provider list with the employees’ paychecks once per year or send out a memo to all employees yearly on who is the required or recommend physicians and other medical providers in the network. The procedures for reporting workers comp claims that I covered in the last few posts are very important. That is where the employer has the initial control of their claims.
Doctor Medical Practitioner Examines Man Workers Compensation Program With Stethoscope

One of the other areas that I recommend to cut workers comp costs is how the employee is treated after the accident. The employees see the medical providers as impartial and so do the Workers Compensation Industrial Boards and Courts. Medical treatment is the make or break area for your workers compensation program other than safety.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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