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.
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:
- 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.
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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