Workers Comp Medical Provider Networks = Medicare Advantage Problems
Why would I compare Workers Comp medical provider networks with Medicare Advantage plans. Many of my retired friends and family have received an ANOC (Annual Notice of Change) letter. They chose the Medicare Advantage Plan instead of a supplemental plan. The Federal Government requires the Medicare Advantage Plan carriers to provide this info.
Employers may not be fortunate enough to receive any type of notification that its injured employees cannot receive treatment at a medical provider’s facility even though the provider has seen its injured workers for years.
Nothing can start out a workers comp claim worse than having the medical provider turn away an injured worker or even worse – make the injured worker provide a personal guarantee or payment.
Let us look at five ways to avoid this situation. None of them require much time.
Five Ways To Keep Networks in Order
- Familiarize yourself with the recommended medical providers. An annual call to your initial treating medical provider takes care of it quickly.
- If you have signed up with a medical network provider, always keep an up-to-date list of local medical providers. Most workers comp medical networks update their list on a weekly basis.
- If a state, such as SC, requires a panel of treating physicians, keep the list up to date including a medical provider to treat dental and eye injuries.
- If the injuries are serious, medical networks are not the priority, get the injured worker to the nearest emergency department. Workers comp medical networks can be worked out later.
- Make sure every supervisor and home office administration staff know where to send the injured employee. This avoids the zombie authorization phone call.
Medicare Advantage Plans are going through their growing pains. Workers Comp medical provider networks seem to cycle every 10 years.
Diary every first week in January to contact your initial treating physician’s office or clinic. 99.9% of the medical providers will be happy to hear from you. The call shows that you care about your employees. Many companies do not make this contact and scramble to have an injured employee treated medically.
