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What is a Medical Provider Network for Workers Comp in California?

A medical provider network is a group of hospitals, medical facilities, and doctors that contract with workers comp insurers to treat injured workers.

This is the answer to a commonly asked question I get from my workers comp clients and I’m going to do my best to summarize this important part of the workers comp system in California.

If your employee gets injured, he or she must be treated in a facility within the network.  It works like this: if your employee gets injured, you take him (or he can drive himself) to a facility that is a part of the MPN that your workers comp insurance company has designated.  This is what you would do unless it’s an emergency that requires a trip to an ER.  In that case, call 911!

It’s actually that simple.  You don’t have to do anything to get set up with an MPN.  When you sign up with a workers comp insurance company, you agree to use the facilities in their MPN.

You may ask: is the network any good?  What if I don’t like their MPN?  What if my employees want to use their own doctor?  These are great questions and here’s my answer:

Your employee may in fact opt out of using the assigned MPN. This option is only available however if your employee completes a Predesignation Form before getting injured. Where do you get a Predesignation Form?  Your workers comp company will send you one when you sign up with them.  It’s a one page form, but requires a little legwork to get it complete: both your employee and the employee’s doctor must agree to the arrangement and sign the form.

As far as the quality of the MPN goes; they are generally very good.  They’re approved and regulated by the state of CA and they’re comprised of qualified, licensed doctors, hospitals, and other health professionals whose sole or primary purpose is to treat workplace injuries.

There you have it – the basics on Medical Provider Networks for workers comp insurance in California.

Also, the CA Department of Industrial Relations’ website has a wealth of knowledge on MPNs, if you want to do some additional pleasure reading.

 

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ELI GILLESPIE

I’m the commercial producer and owner at Gillespie Insurance Services.

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Posted on December 08, 2015 By Eli Gillespie

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Gillespie Insurance Services helps people and businesses in California, Arizona and Nevada.