You might be a high-performing physician if…You are reviewing regulatory requirements and disability management techniques

Posted on 12.18.14

Our third and final post in our three-part blog series, examining what characteristics distinguish high-performing physicians.

The third and final blog in this series looks at whether physicians are fulfilling regulatory requirements and how they deal with disability management. The DWC has become big on timeframes and penalties – if you’re not fulfilling regulatory requirements within a certain amount of time, be prepared to pay a penalty.

If you put in a report three months after a visit, it’s not worth the paper it’s written on because you simply can’t provide valid report information after that period of time.  In terms of best practices for high-performing physicians, Harbor recommends filling out reports on a timely basis.

For reporting and fulfilling regulatory requirements, Harbor recommends the following in order to be considered a high-performing physician:

·        Meet time requirements for submission.

·        Make sure the reports are complete – address all body parts injured.

·        Address causation in initial report and upon request of the claims examiner.

·        Document physical findings on examination to justify the work status.

Looking at these various reporting/regulatory related factors can help determine high-performing physicians, but examining a physician’s disability management technique is important too:


·        Be very specific regarding work restrictions in writing.

·        Assure the injured worker/patient that you, as his or her physician, advocate him/her returning to work.

·        Assure the patient that returning to work does NOT mean that he/she is released from the physician’s medical care.

·        Explain that returning to work does NOT mean the claim is closed.

·        Put specific work restrictions in writing and assure the injured worker/patient if he or she is skeptical, what action to take.


If any billing issues arise, it’s important to ensure that physicians are using appropriate codes for services actually rendered. Just as important, use the accurate diagnosis codes and be sure to monitor the quality of outsourced billing vendors.

If you have questions about how Harbor identifies high-performing physicians, please contact us at the number below.

To learn more about how Harbor Health Systems can help lower claims costs for your organization, contact us today at (949) 273-7020.

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