Rarely Used Medical Providers Stil Key For Employers

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Rarely Used Medical Providers – Employers Put Them on Your Referral List

Let us cover some of the rarely used medical providers that need to be on an employer’s list of workers comp medical treatment referral lists.  Yes, there are some states that allow the injured employee to make their own medical treatment choices.  However, many studies have shown the employee will usually treat where they are directed by their employer.

pic of rarely used medical providers
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One of my Six Keys to Workers Comp savings and claim cost control (while providing excellent care) for your injured workers is having a list of medical providers that can be accessed on a moment’s notice  See my Six Keys to Workers Comp Savings.

First Rule For Using These Providers

The first set of advice for employers remains the same.  Always check with your TPA for self insureds or insurance carrier.  Your company may have signed an agreement in which providers must be used in their medical network listings.

In my claim background, from adjuster trainee to Director, tense situations occurred when these rarely used medical providers did not appear on an employer’s list.  Many other types of rarely used medical providers may be added to an employer’s lists.  The below rarely used medical providers were required in the claims that I reviewed or adjusted during my career.

Dentist – a 24-hour emergency dental practice can be critical.  I recently sustained a severe injury that happened over a weekend.  Waiting for my dentist to open in two days was not a great feeling.

Optometrist/Ophthalmologist – Eye injuries can be a devastating occurrence for an injured employee.

Walk-In Clinics – one cost-saving technique that I have recommended since the 1980s that also guarantees that an injured employee will be seen soon after an injury.

24-hour Pharmacies – especially needed for multi-shift employers.

Radiological Facilities – this one comes as a recommendation that not all radiological facilities may be in your network. Check closely with your insurance carrier or TPA to find the nearest one.

Labs – same as the radiological facilities to stay in your network.

Nearest Emergency Room – no explanation required here.

Remote Providers  – if an employer has mobile employees such as truck drivers, knowing where the nearest medical treatment facilities can be beyond critical for cost savings and proper immediate treatment.

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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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