Medical Provider Networks: Preselecting a Doctor Under CA Workers’ Comp

Some accidents tend to be minor in nature and don’t affect the victims very much. But other mishaps can lead to severe injuries, changing people’s lives permanently. Accidents can occur pretty much anywhere in various situations. But people will expect to be safe in certain places. One of these is while you’re at work. Like any employee, you would assume that your employer will always keep you out of harm’s way to perform your job. Despite this, though, many people in California still get hurt while on the job. In 2015, nearly 500 000 workplace injuries were reported.

How You May Benefit From MPNs

Fortunately, the Golden State has enacted rules to establish the Medical Provider Networks (MPNs). It’s an option for employers to provide prompt and suitable medical treatment to their injured employees. MPNs are basically a network composed of medical service providers. These include licensed physicians and other medical service providers, such as surgeons, psychologists, and optometrists, among others. MPNs are created to provide proper medical care for work injuries an employee in California has sustained. Before this particular benefit can be used, the state’s Division of Workers’ Compensation must have approved your employer’s MPN.

How to Choose a Doctor Within Your Employer’s MPN

One of the required benefits for employees with work injuries in California workers’ compensation is medical treatment. But if you’re an injured worker, you can’t receive treatment by just any medical professional. If your employer has established an MPN, you must get treatment from a doctor within that network.

Every MPN should provide you with a list of medical providers online. The electronic list should give you the ability to schedule appointments. This prevents significant delays from having to wait for the insurance company to provide the necessary information.

You will be required to use the MPN after you’ve filed a claim for workers’ compensation benefits. You need to notify your employer about your injury, and they should provide you with notice that there’s an MPN. Your employer should arrange your initial medical consultation. After your first visit, your employer will inform you of the MPN, how to find the list of medical service providers, and your right to change the treating doctor.

Their MPN notice should include:
 

• MPN contact person and how you can reach them for assistance in locating and scheduling appointments
   

• Steps on what to do should there be trouble in scheduling your appointment
   

• MPN service description and how to access the directory
   

• Guidelines on how to select a doctor within the network and access initial medical care
   

• Directions on how to change your doctor within the MPN and obtain referrals to a specialist
   

• Information regarding the second and third medical opinion process

• Ways to receive an independent medical review from the network

• Description of continuity of medical care standards

If you’re getting treatment from a doctor within the MPN for your work injuries, you will receive mileage reimbursement. This covers pharmacies, physical therapy, trips to and from your doctor’s visits, and other travels related to your work injury.

Accidents can happen anywhere at any time. Having a skilled workers’ compensation lawyer to fight for you will guarantee that you will receive the benefits you’re entitled to. The Law Offices of Daniel Weltin PC in San Leandro, California, can guide you through the entire process. Call us now at (510) 319-1904 to book an appointment.