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Work Comp Fee Schedules – Savings Do Not Stop There


The Savings Do Not Stop With Work Comp Fee Schedules

The Work Comp Fee Schedules have always been a way to cut comp costs.  the savings do not stop there.NCCI had lowered the loss costs or advisory rates for Illinois and Tennessee. The reductions were due to both states enacting fee schedules a few years ago. This will save employers in both states millions in Workers Comp costs.

Graphic of work comp fee schedules no money symbol
(c) 123rf.com

As I said in my post yesterday, there are many other additional savings beyond just a fee schedule. Self insured employers will usually have their Workers Comp TPA also do their bill review. That is a good step as almost all TPA’s have a medical treatment network that will reduce the in-network medical bills by 15%.

The TPA’s will likely offer pharmaceutical, physical therapy, radiological, and many other types of networks.

The same 15% reduction will also be available to non-self insured employers that are paying premiums for coverage with their carrier. The carrier will usually provide various networks similar to TPA’s.

The one big difference between TPA’s and carriers is that carriers will usually only provide one certain network for employers. Sometimes the TPA’s will have multiple networks from which to choose. The self-insured employers will sometimes request the TPA interface with the employer’s own choice of a network.

The 15% reduction is a big IF as the employer has to make sure the injured employees:

Emoticon of work comp fee schedules Sliding on Red Arrow Savings Do Not Stop
(c) 123rf.com
  • Treat in-network and not roll the dice and hope wherever the employee treats is in-network. We have seen in our file review for employers the 15% offered savings was not used as often as possible. Throwing away 15% on med costs can be costly over time, especially in the medical cost spiraling states such as California
  • See the most competent industrial minded medical providers are being chosen out of the network. If a $75,000 questionable medical procedure is performed, then the 15% saving will seem puny at best.
  • Treat with medical providers that are great communicators. As I have said often, communication is the largest cost saver in Workers Comp – no doubt about it. Return to work issues can often be resolved with an open dialogue between the employer, employee, and medical provider.
  • Rehab nurse recommendations – very often the rehab nurse assigned to the file knows the local players in the medical treatment networks better than anyone else. If the rehab nurse has an open dialogue with the nurses of the medical providers that are in-network, you are reaping huge savings.
Graphic Work Comp Fee Schedules Savings

There are many boutique medical providers that will help you as an employer set up the proper medical treatment “in-network” networks. Make sure you check out their backgrounds as we have found some very unscrupulous dealings in this type of network. Biggest is not always the best in this case.

If you want to know of one in your area, email me.   Hopefully, more states will institute work comp fee schedules.

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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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