Are You Spending Too Much for Workers Compensation Healthcare?

Medical cost containment is a crucial issue for employers and insurers in today’s Workers’ Compensation (WC) environment. Some estimate that medical payments account for as much as 60% of all annual WC expenditures. The good news is that thanks in part to companies that provide WC provider networks, the rate of increase of WC healthcare costs, both in real terms and compared to overall healthcare costs, has declined in recent years. (Ibid.) Although there are many networks to choose from, not all of these companies provide the same level of service and savings to their clients.

There are several keys to maximizing the benefits of using a WC network. First, a great network should directly save the payer a significant amount in medical payments. Second, the network should assist payers in the selection of high-quality, in-network medical providers. Third, the best networks assist their clients by streamlining multiple processes, including scheduling, reporting, pre- and re-authorizations, and claims processing and adjudication. While there are many vendors in the marketplace that claim to help with one or more of these processes, few companies provide exceptional service and savings in each of these areas.

The primary benefit of any provider network is medical cost savings. At Direct Pay Provider Network (Direct Pay), we typically save our clients as much as 65% off of Providers’ billed or usual and customary charges. Further, we average state fee-schedule savings of 30% or better. What’s more, Direct Pay clients are assured of receiving these impressive in-network savings on about 90% of all referrals due to our exceptionally high network penetration rate. Whether injured workers need diagnostic imaging, physical therapy, EMG/NCV or a whole range of other ancillary medical treatments, payers can count on Direct Pay’s vast network to provide high-quality, high-savings providers that are convenient to the worker’s home or work.

It’s one thing to have a provider network – there are undoubtedly many networks out there, even in the WC marketplace. What is less common are networks that actively and continuously analyze their data to help payers utilize the highest performing providers in the network. Cost savings on each medical claim or bill is vitally important, but what if payers could reduce the number of medical claims by intelligently selecting providers who treat patients more effectively, thus reducing the number of treatments? That’s precisely what we do at Direct Pay. Our scheduling and management of physical medicine like physical therapy, occupational therapy, certified hand therapy, work hardening, work conditioning, etc. (collectively referred to as PT), provides us with plenty of “Big Data” to analyze in order to guide injured workers to the best, most effective providers in our network. One tangible, critical result of this analysis is that Direct Pay boasts an average of around ten visits per completed PT referral with an extremely low average number of missed appointments. This means that payers are not only saving money on each visit, but they are paying for fewer visits overall and their injured workers, on average, are healing, returning to work, and reaching maximum medical improvement faster. Isn’t that what it’s all about?

Saving money and intelligently selecting the most effective, in-network providers are great ways for payers to reduce WC medical costs. Wouldn’t it be great if there were a reliable, dependable network that consistently provided exceptional service and savings through the entire life cycle of ancillary medical treatments like diagnostic imaging and PT? At Direct Pay, our highly trained team consistently expedites and facilitates care for injured workers through our scheduling, reporting, authorization and claims processing and adjudication systems and processes. One key to our success is that our teams are recruited from diagnostic imaging centers and PT clinics. Our people come to us with years of experience, expertise, and relationships with providers and physicians that simply cannot be matched by other networks. These skills allow Direct Pay to schedule injured workers faster and with the best provider for each referral.

The final key to selecting an exceptional network service is to find one that is willing to customize their processes to the way your work, particularly in terms of reporting and claims processing. Do you ever feel like some vendors offer a one-size fits all solution? Are you forced to modify your processes just to work with a vendor? At Direct Pay, we customize our services to meet your needs, not the other way around. The customer comes first! From making referrals to receiving reports and claims, we have customized dozens of solutions for our clients to reduce the administrative costs associated with a high volume of referrals and medical bills. Direct Pay offers a simple but powerful portal to give adjusters and case managers real-time insights into their claimants’ treatment and progress. We also frequently use fast, secure and reliable data links that can be automated on both ends to increase your productivity and reduce your costs. We also offer a myriad of claims processing options to best fit your existing processes.  This level of IT integration and automation is truly the icing on the cake of exceptional service and savings.

In summary, utilizing a WC provider network is one of the best ways to control medical costs. Choosing Direct Pay Provider Network as your provider network is an even better decision because we provide exceptional service and savings in conjunction with the high-quality, in-network providers.  Our attention to detail and sense of urgency shine through in our scheduling, reporting, pre- and re-authorizations, and claims processing and adjudication processes. Likewise, our IT integration and automation initiatives will take your productivity and savings to the next level. Let us show you what Direct Pay Provider Network can do for you. Give us a call today at (866) 214-5920!