Understanding Your Biggest Challenges
Several weeks ago, we asked you to respond to a survey to help Pinnacol assess the needs of the clinical provider and administrative community we value so highly. Through this research, we have affirmed our positive working relationship with our provider community and gathered ideas for providing increased value.
The goal of this research was to inform strategies to expand communication, content, resources, tools and education for providers and understand the specific and unique needs of subsets of the provider community.
Overall impressions of Pinnacol were very positive, and respondents appreciated that Pinnacol solicits providers’ feedback and focuses on continuous improvement.
One provider said, “From a physician’s standpoint, they’re probably the easiest carrier I work with — especially their accessibility and willingness to talk to me. And aside from the financial side, they’re the easiest one as far as billing is concerned. But I think it’s the personal relationships that really make it unique for me as a physician.”
Seventy-six percent of respondents said they valued interactions with their Pinnacol Provider Relations Specialists, and 75 percent said additional education and resources would further improve their satisfaction with Pinnacol.
Respondents were asked to rate challenges they encountered when handling all workers’ compensation claims:
- Understanding the DOWC rules, fee schedule and treatment guidelines
- Employer relations
- Navigating Pinnacol’s online provider portal
- Injured worker relations
- Billing and coding
When working specifically with Pinnacol, respondents noted these tasks as challenging:
- Managing claims denials
- Understanding the approval process
- Meeting credentialing requirements for accreditation
- Utilizing Pinnacol’s online provider portal
Researchers also discovered that clinic administrators’ and clinicians’ needs were distinct. Administrative professionals said they value education and resources related to claims processing and communication, and clinicians value information about best practices for treating workers’ compensation patients and managing relationships with injured workers and employers. Administrators also said they prefer brief, more frequent email updates from Pinnacol, while clinical providers preferred less frequent and more specialty-specific content.
Education topics were ranked by interest:
- How to bill and code effectively
- Understanding the DOWC rules, regulations and treatment guidelines
- Clinical best practices
- Advanced workers’ comp tutorials
- Basic workers’ comp tutorials
- How to network with other providers and build referrals
Pinnacol teams are hard at work identifying and enhancing the education, resources and tools most valued by the provider community.
Pinnacol recently hired a full-time Network Educator, Laura Palmer, who brings experience in provider relations, education and medical practice administration. Her background includes 12 years in occupational medicine practice administration, 10 years of physician consulting with the Texas Medical Association and, most recently, as the Director of Professional Development for the Medical Group Management Association.
Within the next several months, Pinnacol will be rolling out:
- Enhanced interaction with Provider Relations Specialists. Focus group participants liked Pinnacol’s expanded approach to PRS, and providers will have access to more resources and customized information and education through their designated specialists. Staff will visit clinics more frequently, and the information they present will be customized to meet specific clinic needs, such as coding, documentation or billing.
- Improved timeliness of communication and access to information
- Expanded educational offerings and formats including in-person and online education
- More online resources, tools, information and content
“With input from the provider community, we can provide new and ongoing training for billing, administrative and clinical staff to improve processes and understanding. Through enhanced relationships and closer communication, providers can expect targeted resources and education from Pinnacol. We would love to hear your suggestions for improvement,” said Palmer.