Back to Basics for Workers Comp

Anne Myers


November 1, 2009

In the current economy, companies are looking for ways to reduce costs and maintain profitability. A workers compensation program can be complicated and many business owners and executives are unaware of how to control related costs. In order to get the most out of a workers compensation program, it is important to understand what a good program offers. The following are a few basic areas that any decision maker should evaluate before choosing a workers compensation provider.

Find your perfect provider. When searching for a workers compensation provider, look for a provider that recognizes that workers compensation is a people business so that if an employee sustains a work-related injury on the job, he or she will receive due benefits. A workers compensation carrier should also work with your organization to develop loss control programs to prevent injuries before they occur. Ask about their take on transitional duty programs and how they will help get an injured employee back to work.

Focusing on service. Having a carrier with a commitment to prompt and personalized response will pay off when your firm has an injured employee. Ask your provider about their adjusters' caseloads. Lower caseloads affect the outcome of claims by giving adjusters more time to manage claims and provide a higher level of service. Be sure to also ask if they have a responsive claims call center. A provider with a focus on customer service helps facilitate claim reporting and reduces response time to basic questions.

Managed care matters. Managed care solutions should integrate the people, expertise and technology needed to reach the best claim outcome while containing medical costs. A strategic medical bill review process is important because of the potential savings when there is a workplace accident. The medical bill review process should include utilization review of preoperative and postoperative care, as well as ongoing therapy. A workers compensation provider's attention to appropriate procedures and billing details contributes to savings, more timely bill payment and client satisfaction. An integrated approach to service is an effective strategy to meet the needs of injured workers and getting them back to work as quickly as possible benefits everyone.

Location, location, location. Focus on local market dynamics when evaluating the effectiveness and quality of a medical provider network. Workers compensation claim costs are affected by network quality, accountability and penetration. A workers compensation provider that utilizes a multi-layered medical provider network, with knowledge of local area physicians and pharmacies, can more effectively address the needs of injured workers. It also ensures injured workers are receiving access to the best quality health care and most responsible medical providers in their region. This allows an organization to reduce medical and pharmaceutical costs.

Industry specifics. Partner with a provider that has industry expertise, understands the market and has a track record of success. A company that specializes in workers compensation within your industry has a better understanding of the economic drivers and competitive factors affecting your business. This allows a provider to develop comprehensive, customized and cost-effective programs tailored to the needs of your company. Furthermore, a company that understands your exposures and specializes in workers compensation can help your company achieve better outcomes for your workers compensation program.

Proven outcomes. Look for a provider that has a proven record of success by comparing their results to industry benchmarks. Look for validation from a fully accredited actuary who can attest to the results. Do not simply rely on a statistic cited by a marketing or sales representative.
Anne Myers is the senior vice president of business development and client services for Key Risk Insurance Company, a member company of W. R. Berkley Corporation.