Wisconsin – Workers Comp Medical Cost
I was finishing up my last post on Workers Comp medical costs. I had a research that proved Virginia was the highest in the nation. I then read this article and now I am confused. I think the Augusta Journal article that I referenced was incorrect in my original post. I violated one of my rules in this post – look at the study behind the data.
The Insurance Journal was correct in saying that Wisconsin is the highest state for other than hospitalization medical costs. Virginia was number two on the list. The article I am referring to is the one from WCRI.
According to the WCRI, Prices in Wisconsin for non-hospital services were more than twice that of the 25-state median, and nearly 50 percent higher than the median of the six states with no fee schedules. Even if you ignore the fee schedule states, Wisconsin is still extremely expensive for medical treatment. The E-Mods for employers in Wisconsin are where this will show up in the most dramatic fashion. I am unable to say how much more a 50% medical cost figure would impact the Mod, but it is a heavy factor.
For my last article on this subject, I am wondering how many of the 10 most expensive states are fee schedule and non-fee schedule. I will cover that next week.
The bottom line to all the medical costs comparisons is that the top two states do not have fee schedules. After working in or consulting in basically all 50 states, I can tell you that a fee schedule can help your Mod (E-Mod or X-Mod) drastically.
Unless I am mistaken, most of the non-fee schedule states are U&C (Usual and Customary). U&C may look good on paper as your company can usually receive drastic cuts to the bills. However, the bottom line bill charges are still more than the fee schedule states.
If your company, TPA, or insurance carrier has a PPO network agreement, you can save even more money off the fee schedule rates or the U&C rates. If you are unsure if you are receiving your PPO discount, pulling a few medical bills that are processed and examining them will indicate whether or not you are in a PPO network. The usual PPO discount is 15%.
I always recommend accessing a few of your Workers Comp medical bills and going line by line. By the way, how much are you being charged for medical bill processing? You could be in for sticker shock.
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