Challenges in workers’ comp nurse triage debunked
By Andrea Combs, director of client management, Company Nurse, LLC
Have you been curious about how some employers are able to bring workers’ comp claims significantly down seemingly overnight? Not to mention, employers have found ways to shift indemnity to medical only claims, and at the same time decrease litigation rates. The secret? Nurse triage.
In a real life example, a pool of school districts piloted our workers’ comp nurse triage service with a select group of members and compared data against the non-pilot member group, for the two years prior to the start of the pilot versus the two years of the pilot. The pilot group experienced a 7.5 percent decrease in claims, versus the non-pilot group’s five percent increase. The pilot group had a marked four percent increase shift from indemnity to medical only, compared to the non-pilot group’s one percent shift. To top it off, litigation rates decreased amongst the pilot group, whereas the non-pilot group increased.
With these types of real results I imagine you are asking yourself, “Why wouldn’t every employer utilize this service?” My sentiments exactly, but I have insight into the reasons why some employers see nurse triage services as a challenge – and it tends to start with the perception of enrolling into the program. The reality is many risk management and workers’ compensation administrative departments are so busy administering and handling work injuries that they cannot break away from that role, to implement a program that will give them huge administrative relief…or so they think.
So, I wanted to take a moment to debunk the top five myths of enrolling into our Company Nurse workers’ comp nurse triage program, to illustrate how seamless it truly has been for our clients:
Myth 1: Bringing workers’ comp nurse triage into an organization is a huge undertaking
You and your colleagues are busy and have limited resources; this is particularly true in the municipality sector which has experienced significant budget restraints, and staff may feel stretched thin as a result. While you know the compelling benefits, you think it will be a huge endeavor to integrate nurse triage into your organization, so it is put off. The reality is, we have created a streamlined process that has been refined for 20 years.
Within one to two weeks, it is possible that we can have the entire program implemented into our system and be ready to take calls from your injured workers and receive immediate results.
Myth 2: You need to know a lot about your preferred network and facilities
While we will do need information to set up an organization’s profile and provide comprehensive reporting, it’s really basic information that any organization likely has on file. Straightforward information we would gather includes the addresses of every school in a given school district as an example.
For more complex information, such as the preferred network and facilities, we can help with that. We already have our list of vetted facilities, and can compile any information you need from third-party companies.
Myth 3: You need to be an expert in the workers’ comp field to properly enroll nurse triage
While it is true that there is a great deal of important information as it relates to workers’ comp that will need to be understood in order to appropriately enroll nurse triage into an organization, you do not need to be an expert on all of it. Having worked with employers in all areas of the country, we can share insights on specific state regulations as they pertain to referrals for workplace injuries and we can share best practices in areas like return-to-work, drug testing, and state form policies. We will customize the caller instructions for your organization through this collaborative process.
Myth 4: You have to figure it all out on your own – from third-party vendor collaboration to internal rollout
We operate as true partners, not vendors. We serve as the single-point of contact on your behalf in getting all information needed to launch the nurse triage program, while keeping you informed every step of the way. So, asking another vendor or carrier to send a list, such as a medical facilities list, is a role we can play in working directly with your partners to alleviate the time you may otherwise need to dedicate.
Company Nurse works with brokers, carriers, and third-party administrators in order to jointly set our client up for success. Workers’ comp nurse triage is our core business. We have everything you need or we can develop it, even down to rolling out the new program to employees with tools and training.
Myth 5: This will add another layer to our reporting
This myth couldn’t be further from the truth. 24/7/365, all key stakeholders receive a detailed report in real time as soon as an injury is reported and triaged. The report can also be fed directly into the claims system, which has huge benefits.
Furthermore, state forms can be pre-populated with any information gathered during the triage call and provided back to you in an editable format that you can simply update as needed before submitting to the appropriate agency. No re-entry of basic information is needed, and there is no delay in reporting an incident as all stakeholders receive the report at the same time right after the call. To reinforce: our reporting will provide you with all needed information directly after a workplace injury occurs, saving you a ton of time.
In our process, we partner with our clients from day one with a kick-off meeting to fully understand the scope, and how we can best support you. Our clients have consistent representation throughout and, to my knowledge, we are the only ones that do proactive client management. We then assess the results of the program every 30-, 90-, 180-days, and then annually, to make any appropriate adjustments. Our purpose is to meet your goals.
If you would like me to address any other myths or challenges, reach out at acombs@companynurse.com.
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Founded in 1997, Company Nurse, LLC is a firm that specializes in medical triage and injury management for workers’ compensation and is a pioneer of the pre-claim nurse triage industry. Andrea Combs joined Company Nurse in 2013 to develop the Client Management Department. Later, she moved to Operations to manage Client Services, and has now combined her experience in both areas as the Director of Client Management Services. Combs and her team have the responsibility of enrolling new clients, maintaining those client setups, and managing program outcomes to allow Company Nurse clients to attain the best possible benefits from injury reporting and triage.