Helping Your Clients Reduce Experience Mods with Nurse Triage

 

By Paul Binsfeld, president and founder of Company Nurse, LLC, the premier nurse triage service for workers’ compensation.

This article was originally published in The Standard‘s May edition.

 

Between excessive ER usage, high claims and costs, and insufficient reporting, workers’ comp can be a pain. But the industry has a path to relief; through nurse triage.

Yes, workers’ comp insurance by itself may pay your clients’ claims from workplace injuries, but pair it with nurse triage, and these claims are both minimized and solved more efficiently — resulting in lower experience mods.

When your clients have nurse triage available for the workplace, they also have a solution for better managing workers’ compensation costs.

Here’s how.

Injured Employees have Immediate Access to a Medical Professional

When workplace accidents occur, injured workers and supervisors tend to act in extremes, resulting in either the injured worker going to the emergency room (typically having to wait for two or more hours) or with injuries being dismissed or ignored.

By implementing a 24/7/365 nurse triage program, your clients’ workers have immediate access to a medical professional. Supervisors are no longer left to make medical decisions that they shouldn’t be making.

The nurse can triage the injury, either referring the injured worker to their preferred medical facility or providing them with self-care advice.

On average, 36% of reported injuries warrant only self-care, like applying ice or taking ibuprofen. Injuries that might have been sent to urgent care facilities or even emergency rooms now don’t have to be.

When self-care is the solution for injuries, the incidents stop there — meaning a reduction in the amount of claims your clients have to face. Employers have seen, on average, claims reductions of 15 to 20%.

And with less claims, fewer trips to the emergency room, and reduced urgent care visits, comes much less spending for your clients. Triage can reduce your clients’ workers’ comp costs and their experience mods by up to 30%.

Clients Know their Employees are Using the Right Facilities

When accidents require more attention than self-care, triage nurses can refer injured workers to designated facilities.

Designated means that injured employees are getting treatment from medical providers that have been approved by your clients or their insurance plans. Medical providers that your clients trust and know will not overcharge them for their services.

At Company Nurse, we also verify each of these designated providers. We check their hours, equipment, and services to make sure the injured worker is going to get the right attention.

This reduces wait times for employees, especially since, in most cases, nurse triage helps injured workers to avoid emergency rooms.

And, even in the cases where a critically injured worker needs to go to the ER, the pre-designated hospitals are notified of the employee’s impending arrival.

Your clients can now save countless hours trying to figure out which facilities their employees sought treatment at and if they sought treatment at network facilities.

Your Clients Have Detailed Records and Reports

Before nurse triage, workers’ comp managers could only hope that injured workers would go to the right facilities for medical attention and report the incident in a timely manner.

When an injured employee works with a triage nurse, everything is recorded: how, when, and where the injury occurred; the worker’s personal information; even the nurse’s recommendations. There is no confusion on what happened.

And by giving employees direct access to a nurse, they’re more likely to report their injuries when they actually occur (rather than days, or even weeks after).

Getting these records on the actual day of injury is critical for your clients to have the most influence over both medical care and return-to-work outcomes.

These records are sent in reports to every stakeholder, immediately. Instead of waiting for employees and supervisors to report incidents (or trying to track them down for information), your clients have all the information they need, right away.

Nurse Triage Reduces Litigation

When every incident is recorded and documented by a triage nurse, not only does this ensure that the quality of these triage services is managed, but it also allows for documentation of the incident and a recorded call.

And even though nurse triage reduces the number of claims your clients face by up to 20%, they still occur. Having records and documentation available is crucial in avoiding fraud and reducing litigation.

When your clients provide their employees with triage from a registered nurse, they’re also providing them with peace-of-mind: that their employers care about their well-being and that they will get the medical attention they need for their injuries. And when employees receive real access to medical care from their employers, rates of litigation and questionable claims decline.

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Your focus is to provide your clients with protection from workers’ comp claims. In adding the benefit of nurse triage, your clients’ claims are both minimized and solved more efficiently, reducing their experience mods.

And, with lower experience mods, your clients’ insurance premiums will be reduced — meaning you have happier clients.