Most worker’s compensation provider networks are pretty much interchangeable. Each has a published directory of those medical providers who have signed contracts to join the network, thereby agreeing to allow payors to take steep discounts on the providers’ billings. The networks give no consideration to quality of care, nor to how the providers save the employers money by minimizing time lost from work and returning an employee to functional activity.
The networks sell membership by promising greater utilization by payors – an increase in patient volume that, in our experience, never materializes. What the employers and their insurers do care about, and what influences their utilization decisions most, is getting injured workers back to work through quality care. The “Box O’ Contracts” offered to payors by the networks is something they are happy to take advantage of if available, but seldom influences the choice of medical provider up front.
Many medical providers have no recollection of how they got into worker’s comp networks in the first place, much less what they are to be paid, or how they might go about exiting the networks. The layers of red tape, redundancy, inefficiency, and misinformation cause medical providers to spend four times as much time on a worker’s compensation claim compared to a non-injury claim. Frankly, the networks prey on the sheer difficulty of dealing with them to hope that the provider simply never bothers to challenge its handling of billings.
At MeyerGoergen, in addition to helping providers to recover just payment for their professional services, we help to identify network contracts that may date back decades as well. This allows our clients to determine if the network is actually performing in the manner it promised, or how they can effectively terminate their network relationships for their long term benefit. Instead of being one more contracted provider in the box, our clients can focus on providing high quality care, and then let us work effectively for them in assuring that they are paid as the law requires.
Any medical provider needing help with its worker’s compensation network relationships, or just with getting fairly paid on worker’s compensation billings, should contact MG Law.
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