Managing Healthcare Practitioners To Reduce Workers Compensation Costs

The workers compensation system is the last bastion of medical cost shifting in the United States An employee benefit program typically contains one or more aggressive cost containment techniques designed to curb rising group medical costs. So how does the healthcare industry recoup this income? You guessed it – through the workers compensation system. As a result, worker injury medical costs are catching the full weight of increases in healthcare costs – and there is no end in sight.

To make matters worse, in many state jurisdictions employees can go to any physician they want, making it very difficult to direct the employee to the most cost effective medical service. As a result, your organization will often lose a high degree of control over the quality and delivery of healthcare to the injured employee. In addition, without proper communication between your organization’s Claim Coordinator and the claim adjuster vital information will not be shared with during the first 48-hours of an injury and the organization’s temporary duty program will not be implemented properly. This lack of communication can drive workers compensation costs through the roof.

Finally, many healthcare practitioners do not understand the workers compensation system. They are well trained in diagnosing an employee’s injury and prescribing the appropriate medical care. However, they often struggle with such things as:

• Working with the employer to develop an ADA-compliant accommodation strategy that will get the injured employee back to work as soon as possible;

• Understanding the “essential functions” of the job the employee performs and putting this in the context of return-to-work strategy;

• The impact that “balance billing” has on the employee’s attitude towards their employer;

• The need to communicate frequently with the Claim Coordinator and claim adjuster throughout the process of employee healing;

• Understanding the different classes of disability and what they mean to effective claim management.

• Understanding the regulatory process associated with workers compensation claims and where they fit into it.

It is recommended that your claim management team develop and use a checklist to evaluate medical providers situated in its local area.  It is also highly recommended that members of the claim management team tour the health provider’s facilities as they complete this survey.

The claim management team should take its time in discussions with medical providers. There should be no mystification as to how medical services will be delivered. Remember that poor communication with medical providers can directly short-circuit the organization’s claim management process.

For a free copy of CompEraser’s checklist titled “Occupational Medical Facilities and Services Checklist” please email us at info@comperaser.com.

CompEraser comes with on-line, on-demand resources needed to design and implement an effective PROMPT INJURY RESPONSE system, including this important step in the process. Resources also include the formalization of your safety team, injury prevention, OSHA compliance, safety training, workers compensation disability management, plus more. These resources are available 24/7 and used irrespective of which workers compensation carrier you select. Its patent-pending technology also provides unique financial reports for monitoring the effectiveness of your safety and health program on an on-going basis. For more information visit our website at www.CompEraser.com.