Workers Compensation Doctors

3 Reasons Why Insurance Companies Stop Sending Work Comp Patients to Doctors

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Insurance companies are one of the major sources of workers’ compensation patient referrals. For physicians who accept work comp cases, having a steady source of new patient referrals is essential. However, there are instances when referrals from insurance companies stop all of a sudden, and most doctors are left asking why.

So what should you do if that happens?

The first step is knowing what the problem is. Though it may vary from one adjuster to another, the following are the most common reasons why insurance companies stop sending work comp patient referrals.

  1. The doctor's reputation

    Consider for a moment the position of workers' compensation adjusters and case managers. It is their job to help get injured employees back to work. For this reason, they are keen to avoid doctors who appear to be prescribing excessive treatments and surgeries which will keep the patient out of work for long periods of time. The fact is doctors who repeatedly over prescribe are subsequently viewed as "not work comp friendly".

    As a doctor, therefore, it is important that adjusters and case managers regard you as a doctor who adheres to objective medical evidence and only prescribes medically necessary treatments and surgeries.

    Of course, on occasion, an injured worker may have a serious injury and require extensive treatment. At this point, it is important to call the adjuster and explain the medical necessity. Most adjusters will be willing to approve necessary treatment if the doctor takes the time to explain it to them.

  2. The doctor's office staff

    Even if you are the most talented doctor in the world, adjusters and case managers may still stop sending you cases if they have a poor experience with your office staff. Of course, there are some basic standards for office staff, such as being friendly, helpful, and providing adjusters with what they need as quickly as possible. However, sometimes it goes beyond personalities and is a wider, systematic issue.

    For example, do you have a dedicated Workers' Compensation Coordinator? After all, it can be frustrating for adjusters to speak with a different person each time they call. Having a dedicated point of contact can make the process easier and more efficient, plus leads to a trusting relationship over time.

  3. Lack of marketing

    Unfortunately, in the world of workers' compensation, sometimes the squeaky wheel gets the grease. What this means is that it is the doctors who are the most visible who are, understandably, more likely to be at the front of the adjuster's mind. For this reason, we recommend that doctors are easy to find online, take the time to speak with adjusters, plus provide educational talks or webinars to insurance companies, employers, and law offices.

Knowing the reasons why insurance companies stop sending you workers’ compensation patients is only half the battle. Ensure that you have a good working relationship with adjusters and case managers. And make sure that you’re always on top of their mind by having an effective workers’ compensation marketing plan.

About is the only national directory devoted to listing all work comp doctors in the US. The directory is browsed by thousands of adjusters, nurse case managers, attorneys, and self-referring patients.

If you are a physician who wants to grow your practice, increase your work comp patient referrals by signing up today! And for more information, please do not hesitate to contact us.

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