A few weeks ago, I had the pleasure of hosting a webinar with Brian Stewart, a 23-year veteran of the workers’ comp world. Our goal was simple: to create a practical playbook for practices looking to turn their often-messy WC service line into a real engine for growth.
The good news? Workers' comp can be a high-margin, high-volume business. The challenge, as we discussed, is that it's often buried in administrative sludge that kills efficiency and frustrates your team.
We covered a ton of ground, but a few key themes came up again and again. For anyone building or rebuilding their program, here are the most important lessons from our conversation.
Before you do anything else, you need to understand the game you’re playing. Brian made it clear that your state’s rules around direction of care, whether it's employer-directed or employee-choice, will shape your entire strategy.
In an employer-directed state, the employer decides where care goes. That simple fact changes who you build relationships with and what value you need to offer.
Workers' comp is a team sport involving a whole web of decision-makers: the employer, the TPA or adjuster, the nurse case manager, and sometimes attorneys.
Your success depends on supporting each of those roles. If you can make an adjuster's or nurse case manager's job easier, they will remember you.
This led to what was probably the most important point of the day. As Brian put it plainly, “If you take one thing away from this, track it.”
You have to track the four key players on every single referral: the employer, adjuster, nurse case manager, and carrier.
This might sound obvious, but it’s often overlooked. In many competitive markets, the referral doesn’t just go to the best clinical teamit goes to the fastest one.
The practice that responds quickly, confirms they’ve received the referral, and offers appointment options right away often wins the case
Brian mentioned that at his practice, they aim for a “time-to-first-contact” of under 60 minutes. It's a simple, measurable, and surprisingly effective way to stand out.
You can have the best physicians in the world, but if your intake process is a maze of different phone numbers and unclear instructions, your program will stall.
A centralized intake channel is the solution.
It ensures you capture the right information every time, like the claim number, payer, and authorization status, which prevents countless downstream headaches.
You don’t need to convince every physician in your group to love workers' comp overnight.
Brian’s advice is to start with two or three champions who are genuinely open to learning the playbook.
Help them meet stakeholders and develop consistent timelines for things like ratings and reports. Once they find success, others on your team will follow their lead.
If you want to build trust with adjusters, employers, or nurse case managers, just ask them: “What would make your job easier?”
Sometimes the answer is faster work status notes. Other times, it’s a direct call from the physician on a complex case.
Whatever the answer, building your process around their needs is the fastest way to become their go-to provider.
Workers’ comp often pays two to ten times more than Medicare, but only if you get paid correctly.
Between denials, down-codes, and network mix-ups, it's easy to lose a significant portion of that revenue. We recommend starting a weekly huddle with your operations and finance teams to review underpayments and denial patterns.
You can’t fix the gaps if you don’t see them.
Turning sludge into a scalable system doesn’t happen by magic, but it is achievable.
To help you find your starting point, we built a Workers' Comp Growth Readiness Self-Assessment.
It’s a 48-point scorecard that will help you identify the critical gaps holding your program back.
From there, you can build a simple 30-day plan to start making immediate improvements.
