By Jennifer DeLosSantos
Your business runs on the talents and energy of your people. And despite best efforts to avoid workplace injuries, sometimes they happen. When they do, how do you ensure your valued employee receives the best care possible, and is healthy again soon?
Focusing on better health outcomes is a win for patients and policyholders alike. But most employers have long struggled with the challenge of identifying the best healthcare providers to heal injured workers quickly. That’s where working with a workers’ compensation insurer such as AmTrust can help.
AmTrust leverages the power of more than 40 Preferred Provider Networks (PPO) and state-specific Medical Provider Networks (MPN), whose sole job is credentialing the best doctors available—a process called physician scorecarding. Physician scorecarding technology has been evolving for more than a decade. In that time, a body of data has emerged showing that when the best doctors are utilized, health outcomes are improved with shorter recoveries, lower claim costs, and faster return to work.
When you work with us, you have access to our National Provider Directory, where you can choose from among the best providers in your area, with a history of treating an injured worker and returning them to health faster than other providers in their specialty.
The first step in getting your employee the best care is to be prepared. You want to know what to do and who to call when an injury occurs. And that means understanding the workers’ compensation rules in your state. State workers’ comp regulations vary widely. In some states, employers are required to make a first report within a certain period of time in order for claim consideration. In other states, this is not the case. To become familiar with regulations, visit our website and choose the Workers’ Compensation Claim Kit tailored to the submission requirements of your state.
And keep our care checklist handy for when an injury occurs:
- Take care of your employee. View
the situation with empathy. Reach out immediately
and take the time to listen to their worries and
concerns. And stay in close touch throughout their
- Report the injury promptly. The
earlier the claim is reported, the sooner your
employee can be directed to the best doctors and
specialists. See our tips on successfully
filing a claim report.
- Stay in touch with your adjuster. An
adjuster manages every aspect of care—from the first
doctor visit through rehab and recovery. Three-point
contact is immediately initiated with the injured
worker, employer and doctor. Our Medical Director
assists with proper diagnoses and holds peer-to-peer
reviews to discuss treatment with physicians. And a
Care Concierge may help patients access the right
doctors and ensure the treatment plan is always on
- Rely on us for medical bill mediation. Just because you have access to the best doctors doesn’t mean you should overpay for services. AmTrust provides cost control on your behalf to ensure charges are equitable based upon state or federal UCR (usual, customary and reasonable) fee schedules. We send unjustifiably high bills through audit. And we have a unit that negotiates provider pricing. For example, a rehab facility may quote a $3,000 per day rate. We negotiate reduced rates based upon our presence as a volume provider.
Even in the safest of workplaces, injuries sometimes occur. When they do, you owe it to your people and your business to make sure you keep the wellbeing of your employee front and center from the time the incident happens, through the recovery and back to work process. Showing your employees you care is a morale booster not only for the injured worker—but your entire staff.
Jennifer DeLosSantos is vice president, bill review and managed care for AmTrust North America, a multi-national property and casualty insurer specializing in coverage for small businesses.