States without Fees Schedule Have Higher Medical Fees


It is important that prices of medical services be monitored because they could affect the frequency and quality of workers’ compensation provided. One way to achieve this task is to implement a fee schedule in your state. This fact is even set into stone from the findings gathered by the Workers Compensation Research Institute.

According to the research, states that do not have fee schedules in place pay more for medical professional services offered for injured workers. The fees would also raise faster thereby forcing companies to take necessary actions including, but not limited to, the changes in their workers’ compensation rules. 

Below is a list of the most common practices used by some industries to lower the costs of workers’ compensation:

  1. Not reporting injuries 
  2. Disciplinary actions against workers filing compensation claims
  3. Discrimination against employees who have been injured

In the states of Virginia, Missouri, New Jersey, Indiana and Iowa, the prices of medical professional services are as much as 27 to 51 percent higher than in states with fee schedules like in Louisiana. In Wisconsin, things are even worse with more than twice the median of medical professional fees noted.

States without fee schedules also experience a rapid increase in prices of services necessary to realize the sections of the workers’ compensation in the state. Based on the studies between the years 2002 to 2011, an increase of prices for as much as 50% has been noted. The psychology could be because without fee schedules, professional medical practitioners will not be properly monitored. They can just provide their own charges and the medical insurance companies will just pay them later on. 

Without strict monitoring, the quality of services could also be affected as well. This is especially the case when medical practitioners charge more than they should and insurance companies become more delayed in their payments. 

The most common medical services that charge too much and increase too often are under the following categories: evaluation and management, physical medicine, minor radiology, neurological and neuromuscular testing, emergency care, surgery and pain management injections. 

In Louisiana, aside from being one of the states that implement a fees schedule, it also has some of the most applauded practices to promote safety. These would include:

  1. Documenting the complete details of how workers got injured, as well as the specific violations that led to the injury.
  2. Examining the circumstances leading to a late filing of injury before disciplining an injured worker
  3. Reviewing any incentive programs for the unintended effect of stifling the reporting of injuries.

If the company implements better policies on workers’ compensation, coupled with the most employee- and employer-friendly guidelines by the state, no injured worker will go to court for a dispute. For states with existing fee schedules but still with a relatively high percentage of disputes, formal inquiries need to be set in place. 

Are you in Louisiana and seeking help on a claim dispute? Call John Fox & Associates at (504) 891-3303 or log on to www.johnfoxassociates.com

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