decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Workers' Compensation / Employee Versus Employer or Insurer Choice of Provider
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Article Overview
This piece explains the broad landscape of state workers’ compensation policies on provider selection, comparing employee choice with employer- or insurer-directed care. It is intended for coders, billing personnel, and practices that handle workers’ compensation claims, with emphasis on how state rules and network arrangements affect provider participation and patient access.
Why This Topic Matters
Workers’ compensation provider-selection rules can affect network participation, claim handling, and whether a practice should engage with certain managed care arrangements. Understanding the general state framework helps offices align administrative processes with local requirements.
What You Will Learn
- How workers’ compensation provider-selection rules vary across states
- The general relationship between provider choice rules and managed care or network arrangements
- Why local state rules matter for practices that see injured workers
- The administrative impact of provider-selection policies on workers’ compensation cases
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physician offices handling workers’ compensation claims
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