Medical Cost Containment

In an effort to achieve the maximum cost savings allowed under the Pennsylvania Workers’ Compensation Act, Lackawanna Insurance Group aggressively manages the medical costs of all claims through the effective use of:

  • Provider Panels
  • Medical Bill Review & Re-pricing
  • Pharmacy Program

Development of Provider Panels

The PA Workers’ Compensation Act gives employers the right to establish a list of designated health care providers. When the list is properly posted, injured workers must seek treatment for the work injury or illness with one of the designated providers for 90 days from the date of the first visit. The purpose of the provider panel is to direct the medical care to those providers who specialize in occupational health matters and who have a strong understanding of the Pennsylvania workers’ compensation system.

Careful selection of properly licensed, qualified and responsive health-care providers is essential to contain the medical costs of workers’ compensation claims. Lackawanna Insurance Group will assist all insureds with the development of a functional provider panel. All provider panels are created with consideration given to the following:

  • Client preference.
  • Specialties appropriate for the anticipated work injuries.
  • Quality of care and reputation in their field of specialty.
  • Timeliness of consultations, evaluations and follow-up appointments.
  • Willingness to address return-to-work status and modified duty.
  • Ability to provide timely written medical reports.

Pharmacy Program

Lackawanna Insurance Group has partnered with Helios as our preferred provider of pharmacy benefit management services for workers’ compensation claims.

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Medical Bill Review

All medical bills submitted to Lackawanna Insurance Group are reviewed and re-priced according to the Pennsylvania workers’ compensation medical fee schedule. In addition to the State allowed medical cost reductions, Lackawanna Insurance Group, in conjunction with our carefully selected contracted vendors, provides its insureds access to some of the most comprehensive PPO and Physical Therapy Networks in the State of PA. The savings realized through the discounted networks are significant and are unbeatable when compared to any other managed care or PPO Networks in the State.