Workers Comp Medical Specialty Networks – My Recent Experience

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Workers Comp Medical Specialty Networks – Immediate Referrals Key

Workers’ Compensation medical specialty networks should be part of every employer’s network, not just the one provided by your insurance carrier or TPA at renewal.   Immediate referrals fulfill part of providing injured employees with immediate care while cutting Workers’ Comp costs.

I have often posted, presented, and provided advice on the SECOND LEVEL providers beyond the initial treating physician.  The Six Keys to Cutting Workers’ Comp Costs list that I wrote in the 1980s still stands today.  The original list was actually four. I added two more over the years.

One of the Original Four Keys

Workers comp medical networks provide faster care and save WC $.   Medical networks that an employer establishes, even specialty networks, ensure that employees who incur uncommon injuries still receive immediate care. See this recent article on networks.

My Own Experience

Recently, I had a serious eye infection.  I had an unofficial medical network set up, as my Optometrist saw me the next morning after I called in with an immediate medical concern.  If I did not have an informal eye care professional established for care, where would I have gone?  How long would I have sat waiting for an appointment?

The same goes for injured employees. Workers’ Comp medical specialty networks would work the same way.  If an employee gets metal in their eye, where would you send them for immediate treatment?

The Optometrist treated me for five days and decided to make an immediate referral to an Ophthalmologist with a Stat referral.  One of the business offices in Raleigh worked me in the next business day.  I had a very serious infection – long story.  The Ophthalmologist gave me two very potent prescriptions, which have corrected my vision almost back to normal.

All of this happened in two weeks with a major Holiday in the middle.  I will see the Ophthalmologist again next week.   That totals four appointments in three weeks with two medical specialists.

Workers Comp Medical Specialty Networks – Bottom Line

Know where to send your injured employees, even if they have uncommon injuries, even if they are not the usual original treating physician where you usually send them.  It worked for me.  It can work for you.

pic Doctor patient medical specialty networks
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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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