Medical management is one of the most important aspects of controlling
WorkComp costs. While frequency of claims is declining costs have skyrocketed.
Although you may feel you have little control over the medical treatment
your injured employee receives, there are several steps you can take.
And the payoff is significant.
One of the most effective approaches is hiring an independent nurse.
Depending upon the volume of your claims, the nurse can be an outsourced
position or a part- or full-time employee. The most important point is
that the nurse is independent and understands how a treating physician
and insurance adjuster work. The nurse's role is improve the injured employee's
treatment and serve as a liaison between you, the employee, the medical
provider and the insurance company, thus improving claims management.
Here is what a nurse can do:
In addition, a nurse will enhance employee morale by providing a safe, accessible
workplace and promoting a healthy lifestyle conducting blood pressure checks,
assisting in chronic disease management and other items to keep your employees
healthy and working. With an independent nurse, you will be able to produce
better outcomes for your employees, expedite a safe return to work and prevent
overutilization of medical treatment.
- Review treatment plan from physicians and clinics to make sure treatment
is timely and appropriate
- Advocate for the employee to be sure he/she receives prompt,effective
- Assess temporary alternative job duties for the employee
- If appropriate, accompany the injured employee on medical appointments
- Assist the injured employee with getting needed prescriptions, medical
aids, etc. Helping the employee and developing a positive relationship
early in the process goes a long way in encouraging a return to work.
- Build a relationship with the injured employee's medical provider
and make the doctor aware of the employee's duties and possibilities
of limited-duty assignment
- Know the medical resources in your area. Knowing the highly qualified
specialists and rehabilitation practitioners who provide objective medical
care is critical to cost control
- Help in the selection of rehabilitation care. Physical and occupational
therapy is one of the most significant cost drivers for workers' comp
injuries and key to controlling those costs is using providers experienced
in managing care and getting patients back to work
- Monitor the work site and provide medical input for safety meetings