Workers Comp Physician Networks Now More Critical to Cut Comp Costs
One of the Six Keys or Secrets to cut your work comp costs becomes even more important now due to a fact covered later in this article. Workers Comp physician networks are a great risk management technique that involves little cost and a little effort to put in place.
I wrote the Six Keys as Four Keys that I saw as important when adjusting claims in 1988. I then added two more as time passed and I was exposed to more workers comp reading material – thanks Interweb.
Workers Comp physician networks became your go-to way as an employer after safety. Yes, the old boring slogan – the least costly accident is the one that never happens- remains the best way to cut your workers comp costs.
I have given the presentation at least 25 times on how I picked up a file from a suddenly unemployed adjuster. Reviewing the file was a shocker as the main treating physician was a biofeedback specialist (nothing against those practitioners). When I show a diagram of an out-of-control medical treatment network, many mouths open wide in astonishment. A $400 claim turned into a $745,000 claim due to no medical treatment network.
Setting up the Network – Quick Primer
One main consideration to cover is where the injured employee should treat in the general vicinity of their workplace. A physician’s office must communicate well. Treating physician communication covers:
- Sending timely medical reports and bills
- Answering claims adjuster inquiries
- Understanding the job description for a return to work
- Communication with rehabilitation nurse (if assigned)
- Referring to a second-level physician in the network (if necessary) – (i.e.) Orthopaedic Surgeons, etc.
- In emergency situations, medical treatment networks should be ignored
- The best person on earth to ask about immediate great medical treatment – the claims adjusters.
Adjusters who are reading this will add in at least a few more bullet points.
Salient Point On States With Employee Choice of Care
Some states do not allow direction of medical treatment whether by a panel or directed by the employer. Most studies have shown that injured employees will actually still see an employer-recommended physician even if they can choose the medical provider.
I apologize for not sourcing those studies.
Why Is A Workers Comp Physician Network Critical Now?
WCRI, NCCI, WCIRB, any of the independent rating bureaus, and many studies have pointed out a very major fact which is:
- # of claims severely decreasing – good news
- Cost of claims severely increasing – bad news for risk per claim
Check slides 23 and 24 of this NCCI presentation that I attended last year. These are national figures. You may want to read the whole group of slides. It will be worth your time.
The average claim according to a WCRI nationwide study was $42,000+. When an employee reports an injury to their respective employer, the time to take action is RIGHT THEN. The employer at that time needs to:
- Direct medical care to your network or;
- Offer a panel is states that require a panel or;
- Recommend a physician in states where the employee can those their medical treatment
Each claim now impacts your E-Mod or budget (self-insureds) more every policy year. Self-insureds are paying more per claim directly out of a budget.
Bottom Line – Controlling medical costs upfront by referring an employee to a trusted industrial-minded physician cut your work comp costs dramatically. With the number of claims decreasing, an opportunity to control losses may not as often come an employer’s way as in the past.
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