Why Did My Doctor Tell Me to Treat Through Private Insurance?

As Lake Worth workers’ compensation lawyers, we hear clients telling us this, or a very similar statement, all the time. What it means to the medical provider is they can make more money providing the exact same treatment and care under your group health or personal insurance than they do under the workers’ compensation fee schedule.

When a Lake Worth – or West Palm Beach work injury lawyer hears a client say that their work comp doctor won’t provide any care under the work comp case, but will gladly treat under health insurance, we know that this doctor does not have the client’s best interest at heart.

As Lake Worth work injury compensation lawyers, we also realize that this means you, the injured worker, are not getting the best care possible and will suffer. It is our goal to make sure that we help steer you in the right direction to maximize your ability to heal from your workplace accident or injury.

What happens is that when a medical provider, whether it is a walk in clinic, an orthopedist or a surgeon, agrees to accept work comp patients they are really agreeing to be paid a certain amount of money for their time. Most medical providers will be paid more for the initial visit that subsequent visits, so they get their bang for the buck in the first few visits and then declare that the injured worker is suddenly healed and requires no further care.

The work comp fee schedule, the set rate at which medical care is paid, is pretty much a nominal percentage of what Medicare or private insurance would pay. So how does the doctor make their money? Think of it this way. If you were paid $500.00 to treat a patient through health insurance, but only paid $100.00 to treat a patient through work comp, how would you structure your practice?

The answer is volume. You treat five times as many patients under work comp as you do with health insurance to make the same $500.00.

Work comp patients will recognize a volume practice when they think of the waiting rooms that are packed to overflowing with people. Ever have an appointment at one time and sit and wait for two hours to be seen?

When you have been hurt at work, call an experienced Lake Worth workers’ compensation lawyer. We can help you so that if, or when, you are sent to a work comp doctor, you will know exactly how to maximize your very short time with the medical provider to obtain the best results: medication, diagnostic studies, surgery, treatment and care. Contact the The Law Offices of Franks, Koenig & Neuwelt for a free case evaluation.