• Menu
  • Skip to main content
  • Skip to secondary navigation
  • Skip to primary sidebar
  • Skip to footer

Before Header

  • About
  • Search
  • Resources
  • Privacy
  • Contact
 

Amaxx Workers Comp Blog

Reduce Workers Compensation Costs By 20-50%

Header Right

  • Home
  • Books
    • Big Book
    • Mini Book
  • Training
    • WC Mastery Membership
    • Course Curriculum
    • Certified Master of Workers’ Compensation
    • Certified Master of WC – Best in Class
  • Coaching
    • CompElite Strategic Coaching for Employers
    • BrokerElite Coaching for WC Business Growth
  • Software
  • Blog
  • Advertising

Mobile Menu

  • Home
  • Books
    • Big Book
    • Mini Book
  • Training
    • WC Mastery Membership
    • Course Curriculum
    • Certified Master of Workers’ Compensation
    • Certified Master of WC – Best in Class
  • Coaching
    • CompElite Strategic Coaching for Employers
    • BrokerElite Coaching for WC Business Growth
  • Software
  • Blog
  • Advertising
  • About
  • Search
  • Resources
  • Privacy
  • Contact
You are here: Home / Medical & Pharmacy Management / Direct Healthcare to Reduce Work Comp Costs

Direct Healthcare to Reduce Work Comp Costs

March 22, 2022 By //  by Michael B. Stack

Interested stakeholders seeking to reduce workers’ compensation program costs should proactively direct the care an injured employee receives. When this is done effectively, there can be an immediate saving in workers’ compensation program costs. There are also other intangible benefits that this group should consider. Now is the time to change and become engaged in this area.

Choosing the Treating Doctor

Employees in most jurisdictions have the right to choose their healthcare provider. Each jurisdiction has its criteria for when this occurs and usually excludes where the employee is seen immediately following a work injury. The general rules for the selection of a treating physician usually include:

  • A time limitation of 30-60 days following the work injury; and
  • Once, an employee treats a doctor on two consecutive occasions.

Click Link to Access Free PDF Download

“The 6-Step Process To Determine Workers’ Comp Injury Causation”

Once the selection is made, the employee needs to demonstrate a change in provider is in the “best interests of the parties.” Requests to change a healthcare provider after the initial selection should be made with the assistance of in-house or defense counsel.

The employee’s right to choose their treating doctor does not preclude the defense interests from being proactive and directing healthcare by making suggestions or recommendations. Proactive employers can establish a relationship with a healthcare provider group for employees to see following workplace injury.

Tools to Direct Healthcare in Work Comp

Employers and other interested defense interests can take other proactive steps in directing healthcare following a work injury. Implementing some of these resources will pay immediate dividends.

  • Telephonic Nurse Injury Triage: This service is usually provided telephonically and provided by a nurse who is on call. A supervisor or manager can call these healthcare professionals following a work injury and receive instruction on how to care for an injury and determine if additional medical care is required.
  • Field Case Management: This service is also provided by a nurse and can assist in guiding a claim handler on how to deal with issues concerning lost time from work, strategies to help employees not miss medical appointments, and recognizing the care that is not consistent with clinical guidelines.
  • Utilization Review: This service includes prospective, concurrent, and retrospective reviews of an employee’s medical care. The goal is to identify whether the care being recommended by the treating doctor will cure and relieve the effects of the work injury.
  • Medical Advisor and Directors: This service is usually performed by an in-house physician or contracted medical doctor who can review claims, clarify what medical care may be needed, and make recommendations on moving a file to settlement or closure.

These are some of the many tools available to employers and insurers interested in resolving troublesome files and seeking to reduce program costs.

FREE DOWNLOAD: “The 6-Step Process To Determine Workers’ Comp Injury Causation”

Consider Med-Legal Conferences for Troublesome Claims

Some claims require the medical and legal interests to meet and confer regarding the direction of a claim. These conferences involve the claim handler, defense attorney, and medical advisor. The goal of the med-legal conferences is to:

  • Assist the defense attorney in understanding the complex medical nature of a claim;
  • Assist the medical advisor to understand how the legal issues impact ongoing medical care; and
  • Assist the claim handler in developing a strategy to move the case forward cost-effectively.

Sometimes it takes the knowledge of the collective whole to solve problems. The use of a med-legal conference can accomplish this complex goal. Tools used before such conferences include physician peer review services and the independent medical examination.

Conclusions

Controlling workers’ compensation program costs include the need for defense interests to be proactive and direct the post-injury medical care of the employee. There are limitations to what can be done. Notwithstanding these barriers, they can seek to provide medical to the employee following an injury within a network of doctors at nearby locations. They can also use specific tools that assist in evaluating the injury and ensure only reasonable and necessary care is being provided. There can be an immediate reduction in medical dollars spent on a claim when done correctly.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a 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 the founder & lead trainer of Amaxx Workers’ Comp Training Center, which offers the Certified Master of Workers’ Compensation national designation.

Contact: [email protected].

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

©2022 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

FREE DOWNLOAD: “The 6-Step Process To Determine Workers’ Comp Injury Causation”

Filed Under: Medical & Pharmacy Management

Related Articles

Demystifying Evidence-Based Medicine in Workers’ Compensation

Demystifying Evidence-Based Medicine in Workers’ Compensation

2 Common Mistakes In Workers’ Comp Doctor Selection

2 Common Mistakes In Workers’ Comp Doctor Selection

Workers’ Compensation Medical Director Best Practices

Workers’ Compensation Medical Director Best Practices

5 Proven Strategies for Physician Oversight to Contain Workers’ Comp Medical Costs

5 Proven Strategies for Physician Oversight to Contain Workers’ Comp Medical Costs

Use A Medical Advisor To Maximize Value of Independent Medical Exam

Use A Medical Advisor To Maximize Value of Independent Medical Exam

Red Flag: Time to Get an Independent Medical Examination

Red Flag: Time to Get an Independent Medical Examination

Workers’ Comp Medical Causation: Getting Primary Liability Decisions Right

Workers’ Comp Medical Causation: Getting Primary Liability Decisions Right

Dealing with Long COVID-19 in Work Comp

Dealing with Long COVID-19 in Work Comp

7 Practical Tools to Reduce Workers’ Comp Medical Costs

7 Practical Tools to Reduce Workers’ Comp Medical Costs

8 Factors to Consider Before Denying Workers’ Comp Medical Care

8 Factors to Consider Before Denying Workers’ Comp Medical Care

Chronic Pain: Handling Pain in the Butt Claims

Chronic Pain: Handling Pain in the Butt Claims
Field Nurse Case Manager

Reducing Work Comp Costs With Field Nurse Case Managers

Reducing Work Comp Costs With Field Nurse Case Managers

Train to Succeed

BECOME CERTIFIED IN WORKERS’ COMPENSATION

Proven Course Catalog & WC Toolbox Give You The Power To Achieve Lower Costs and Better Injured Worker Outcomes

VISIT WORKERS' COMP TRAINING CENTER

Free Download

The 6-Step Process To Determine Workers' Comp Injury Causation - FREE Download Click Here Now!

Previous Post: « Select the Workers’ Comp Claims Administrator
Next Post: Seven Reasons Med-Only Claims Become Lost Time »

Primary Sidebar

FREE DOWNLOAD

The 6-Step Process To Determine Workers' Comp Injury Causation - FREE Download Click Here Now!

Our Sponsors

Catastrophic and Risk Solutions, Case Management Solutions, and Specialty Networks
 

Injury Management Solution for Employers

Blog Categories

Search Our Archive

Subscribe to Our FREE Newsletter

Return-to-Work Essentials

Footer

Search Our Archive

Search our continually growing archive of over 5,000 articles about Workers' Comp issues.

Quiclinks

  • Calculators
  • Terms & Abbreviations
  • Glossary of WC Premium Terms
  • WC Resources
  • Best Practices
  • Industries
  • Return-to-Work Essentials

RSS Recent Blog Posts

  • From First-Day to Fully Trained: The Overlooked Power of Onboarding in Injury Prevention
  • From Integrity Tests to Physical Exams: A 6-Step Hiring System to Reduce Workers’ Comp Claims
  • The Hidden Costs of a Bad Hire: Why Employers Can’t Afford to Ignore Hiring Risks
SUBSCRIBE TO OUR FEE NEWSLETTER
Let Us Help You Stomp Down the High Cost of Workers' Comp!
Top of Page ↑
  • Home
  • Training Center
  • Search
  • Membership
  • Products
  • Blog
  • About
  • Contact
  • Subscribe
  • Login
Copyright © 2025 Amaxx, LLC. All Rights Reserved. · Privacy Policy / Legal Notice