The Truth About Increasing “Medical Costs” In Workers’ Compensation

By: Admin

doctor-writing-on-clipboard-2-uid-1I continue to hear employers and insurance companies discuss the crisis of increasing costs of medical treatment, with employers seeking cuts in medical costs for injured workers on the mend. In my 32 years of experience helping injured workers, legislature has yet to increase access to medical care for injured workers. Unfortunately, legislature has only cut these benefits over the years, with even more medical care currently on the chopping block. These cuts may very well drive more doctors out of workers’ compensation system.

The problem lies with what insurance industries label as medical costs. Insurance companies and self-insured employers typically hire case management companies to send nurses to meet with an injured worker, go to doctor’s appointments with the injured worker, and sit in on doctors’ exams with the injured worker. These nurse case managers are, in many instances, paid more for attending theses doctor’s appointments than the doctor that’s treating the injured worker.  Nurse case managers typically bill by the hour, so the substantial time it often takes to be seen by a medical professional can lead to a large bill for their services.

Most doctors get paid around $50 for an office visit while a nurse case manager may charge in excess of triple that amount per visit, despite the fact that the nurse case manager does not provide any care or treat the injured worker. This often large bill is labeled as a “medical cost” by insurance companies, though it is more accurately described as an administrative expense. This is a matter that the insurance commissioner should look into correcting, forcing insurance companies to properly list only actual medical care administered to injured workers as a medical cost. This would drastically cut reported medical costs, making for a much better representation of the actual cost of medical care and treatment to injured workers in Florida.

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