Hello. Michael Stack. Principal of Amaxx, founder for COMPClub and co-author of Your Ultimate Guide to Mastering Workers’ Comp Cost. I want to give you a success tip that actually comes out of the 2016 version of Your Ultimate Guide to Mastering Workers’ Comp Cost, it is the fifth step of the five-step system to reduce your cost by 20 to 50%. That step is in regards to medical and pharmacy cost containment.
7 Considerations To Use in Doctor Selection:
When we talk about managing workers’ comp claims and reducing workers’ comp cost, one of the things that we often forget is that these are medical injuries, and they need the expertise of medical providers for the healing and recovery of those injuries. I want to give you seven considerations to use as a reference point for the selection criteria of the medical providers that you work with at your organization.
Now, when it comes to doctor selection the laws are going to vary by states. You’re going to want to definitely check with your jurisdiction. It’s either going to be an employee-directed state, an employer-directed state, or often times a blend of those two. There are some states where the employer can have zero input whatsoever, so be sure to check with your state laws. Often times even in an employee-directed state, you can do what’s called soft channeling by setting up relationships with high quality providers and giving a recommendation to your employees to go to see them if they chose.
Care & Credentials
Let’s talk about these considerations and some of these criteria that you should use. Of these seven considerations, there’s really two main categories that they’re going to fall under. The first is care and the second is credentials. The first category is care, how much those providers care, and the second is what are their credentials. Let’s talk about some specifics here.
Be responsive to employees’ needs and willing to return them to work
The first thing that you want to look at in regards to care is you want to talk about how much responsiveness do they have to your employees? Responsive to your employees’ needs and a willingness to return them to work. Responsive to your employees’ needs and a willingness to return those employees to work.
Visit your organization
Second criteria here is that they visit your company. They actually go to your job site to visit your employees and find out what type of work they’re doing on a regular basis, get to know your organization, and at the same time be willing to use your forms in your return-to-work program in order to get the medical restrictions and get them back to work to work within your system. Their responsiveness, their willingness to return them to work, and then also visiting and understanding what those job descriptions are understanding what type of work your employees are doing, and using your forms to feed right into your system.
Be available to schedule employee’s appointments without delay
Selection criteria number three is scheduling appointments. You want to make sure that your employees can get in to see these providers easily. One of the studies that WCRI just recently came out with was in regards to worker outcomes, and the ability for the employees to get the care that they needed was one of the biggest factors in determining whether they would ever come back to work. The ability to get the care that they needed was one of the biggest factors in determining whether they would ever come back to work, so being able to get in to see those providers is a key selection criteria.
Spend extra time with your employees as needed
The last criteria here is time. How much time are those providers able and willing to spend with your employees? If you’ve ever studied human relations, you know that one of those principles is people don’t care how much you know, until they know how much you care. People don’t care how much you know, until they know how much you care. That’s what this first set of criteria (is about), this first selection criteria, is making sure those providers care to work with your organization and they care about your employees and what’s best for them, which is getting them back to work.
Possess outstanding medical credentials and an excellent reputation
Let’s talk about these credentials, because if you have this down, then of course, the quality of those providers is an extremely important piece as well. The first thing you want to look at is their credentials, their actual medical credentials and their reputation in the community. What is their background? What is their expertise? What is their specialty, and then what is their reputation in the community? You obviously want to work with a very high quality provider to provide your employees with the highest level of medical service that’s available.
Provide medical records and reports timely, be available for consultation with claims team
Number two then. In regards to working with your claims management team, you need to be able to get the reports and any records and any communications and conversations that need to be had with your adjuster, with your nurse case manager, and with your claims management team, providing reports, providing records, and having conversations. Their ability to provide that information to ensure your employee is getting the best medical treatment, to get the best medical outcome, getting them back to work, and by the way, that will lead to the lowest amount of workers’ compensation cost.
Provide detailed medical restrictions for return to work
A final point then, and probably most important from an employer standpoint, is be able to get restrictions for return to work. To be able to get restrictions, the medical restrictions, to understand what that employee can do safely and productively at your organization in a return-to-work program. You need to have them sign off that they’re able to go back to work and understand what those restrictions are. For example, they have a 10-pound, a 20-pound, a 30-pound weight-lifting limitation, they can only stand for a certain number of time, etc, so understand what those restrictions are, have it written out in your form, and get those employees back to work as soon as possible.
That’s the selection criteria for your medical providers. Remember, your success in workers’ compensation will be determined and defined by your integrity, so be great.
Author Michael Stack, Principal, COMPClub, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder of COMPClub, an exclusive member training program on workers compensation cost containment best practices. Through these platforms he is in the trenches on a working together with clients to implement and define best practices, which allows him to continuously be at the forefront of innovation and thought leadership in workers’ compensation cost containment. Contact: [email protected].
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.
