How Does a Medical Provider Network for Workers Comp Work in California?

First, let’s define Medical Provider Network (MPN). An MPN is a group of hospitals, medical facilities, and doctors that your workers comp insurer uses for treating injured workers.

If your employee gets injured, he or she must be treated in a facility within the designated MPN.

It works like this:

• You, the employer, get a workers comp policy
• Your workers comp policy uses medical providers within a specific MPN
• Your workers comp carrier makes the MPN information available to you – typically through their website, so you know where to send your employees in case of job-related illness or injury.
• [Time Passes]
• Your employee gets injured on the job
• Your injured employee drives to a facility that is a part of the MPN to get treatment.

Note: if it’s an emergency call 911 and/or head straight to the ER!

That’s it! It’s really about that simple.

One interesting question I sometimes get is whether it is mandatory or not to use a provider within the MPN. Can an injured employee use the doctor of their choice that happens to perform services outside of the MPN?

The answer is, yes, your employee may in fact opt out the assigned MPN and use their own doctor. This option is available, however, only if your employee completes a pre-designation form – before getting injured. This is a form that you would have to request from your workers comp company, and both the employee and the employee’s doctor must agree to the arrangement and sign the form.

I noticed the concept of pre-designating a doctor use to be more common in the first 10 years after 2005 when MPNs were established in California. As healthcare has changed over the most recent ten years, far fewer people are pre-designating specific doctors than they used to. So in the real world, if you call your agent or your workers comp company today asking for a Pre-Designation form, you’ll most likely get asked back, “What’s a Pre-Designation form?” Kind of interesting.

This is pretty high level look at MPNs, so if you want to dig deeper into the details of MPNs, here’s a link to the CA Department of Industrial Relations’ website, which has everything you’ve ever wanted to know about MPNs and more.

AND LASTLY, if you’re looking to save money on your workers comp, just click on the “Schedule a Call” or “Send Email” button below.

Our process is simple:

1. Set an appointment. Just click on one of the buttons below!
2. Have a conversation. We’ll learn about you and your business, gathering all the information an insurance company needs to offer a quote.
3. Present your quotes. Once we’ve received the best that the market has to offer, we’ll reach out to you to present your quote and review the best offer for you and your team.