Column: Workers' Comp

Transparency’s Promise 

By: | February 22, 2016

Roberto Ceniceros is a retired senior editor of Risk & Insurance® and the former chair of the National Workers' Compensation and Disability Conference® & Expo. Read more of his columns and features.

The word transparency gets thrown about so often that it brings to mind the hyperinflation that occurs when a country excessively pumps out currency.

Print too many dollars without comparable economic growth and a consumer needs a wheelbarrow full of those dollars to buy a single loaf of bread.

The promise of transparency is similarly devalued when the word is constantly uttered, yet less frequently delivered on.

Smart employers shopping for workers’ compensation services already know the sales promise of transparency should be weighed alongside another concept: caveat emptor.

While transparency is often the promise of the day, workers’ comp products, service charges, and service-provider assurances may neither be transparent nor quality proven.

It’s the risk manager’s job to be wary, so their employers get the quality they pay for and injured workers get the attention their circumstances merit.

Companies providing products and services for risk managers frequently tout the transparency they provide. Bill review companies eagerly pitch how their services make medical charges much more transparent.

Standard medical provider discounts and billing practices are so convoluted that, without question, bill review is an essential service.

But charges for bill-review services can also lack the necessary  transparency.

The promise of transparency is devalued when the word is constantly uttered, yet less frequently delivered on.

Obfuscation of charges for bill review services can occur along the supply-chain route as bill review products are sold to claims administration service providers who then resell the services to their clients.

There are plenty of creative fee structures that are still applied to obscure the true cost of bill-review services.

There are also more examples of employers and other claims payers countering this by negotiating for flat or capped fees.

Those buyers conducted their due diligence before signing the contract. It is now easier for them to reduce their claims management expenses by understanding the charges they are billed for.

Plenty of other employers haven’t figured this out or they don’t have adequate resources to evaluate the products and services they buy.

Bill review is just one among many workers’ comp products employers purchase.

I fear that finding transparency and superior product quality are increasingly demanding tasks when claims management has grown ever more complex.

Transparency, however, remains an important goal. Employers can demand proof of it.

But they could also be helped by upper management providing adequate resources to properly manage vendors.

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