A Direct Pay
Provider Network, LLC
From The BLOG

Are You Spending Too Much for Workers Compensation Healthcare?

A person's hand being wrapped in gauze after being injured on a job site.

Medical cost containment is crucial for employers and insurers in today’s workers’ compensation environment. In 2017, it was reported that medical payments account for as much as 60% of all annual workers’ compensation expenditures. The good news is that thanks in part to companies that provide workers’ compensation provider networks, the rate of increase of workers’ compensation healthcare costs, both in real terms and compared to overall healthcare costs, has declined in recent years. Although there are many networks to choose from, not all of these companies provide their clients the same level of service and savings.

There are several keys to maximizing the benefits of using a workers’ compensation 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.

Medical Cost Savings

The primary benefit of any provider network is medical cost savings. At Direct PT/DX, 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, our 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 PT/DX’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 workers’ compensation 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 PT/DX. 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. On average, their injured workers heal, return to work, and reach maximum medical improvement faster. Isn’t that what it’s all about?

Top-Notch Services & Savings

Saving money and intelligently selecting the most effective, in-network providers are great ways for payers to reduce workers’ compensation medical costs. Wouldn’t it be great if a reliable, dependable network consistently provided exceptional service and savings through the entire life cycle of ancillary medical treatments like diagnostic imaging and PT? At Direct PT/DX, our highly trained team consistently expedites and facilitates care for injured workers through our scheduling, reporting, authorization, 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.

Customized Services

The final key to selecting an exceptional network service is to find one willing to customize its processes to how you work, particularly in 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 PT/DX, 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. We offer 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 productivity and reduce costs. We also offer a myriad of claims processing options to best fit your existing processes. This IT integration and automation level is truly the icing on the cake of exceptional service and savings.

In summary, utilizing a workers’ compensation provider network is one of the best ways to control medical costs. Choosing Direct PT/DX as your provider network is an even better decision because we provide exceptional service and savings in conjunction with 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. Learn more about about reducing workers’ compensation costs with Direct PT/DX.

Contact Direct PT/DX today! (866) 214-5920 | scheduling@DirectPTDX.com

More From the Blog

The Benefits of Using Medical Scheduling for Workers’ Compensation Claims

Meet Joe. He works as a painter and is climbing up ladders on a regular...

Medical Provider Network: What It Is & Its Role in Workers’ Compensation

Generally, a medical provider network (MPN) is a group of medical and healthcare providers including...