By Meaghan Tyndale-Williams, Risk Advisor 
Protecting the health and well-being of your employees should be a top priority for every company; however, no business is injury-proof. Organizations of every size have to deal with multiple workers’ compensation claims each year, which can be overwhelming for the person in your office who has to file with the insurance company. Oftentimes, mistakes are made, and the claims are not handled properly. Ultimately, this can cause the insured quite a lot of money if claims are not reported properly.
Fortunately, there is a new solution to handling these types of claims that is quick, efficient, and reliable. It’s called the nurse triage program.
Similar to telehealth, which became very popular during the COVID pandemic—nurse triage is an injury hotline which enables employers to respond to workplace injuries at the most critical point—the day the incident happens. The worker simply calls the hotline and speaks with a workers’ comp nurse who is fully skilled in asking the right questions and filing an accurate report. They will then help the worker determine the most effective course of action after an injury by either providing self-care advice or directing the individual to an appropriate level of care. Implementing immediate action can reduce the likelihood of lost workdays. Within 24 to 48 hours, the triage nurse makes a follow-up call to the injured worker to assess status, satisfaction, and provide additional guidance, if needed. We have found that the outcome of a claim tends to be better when a worker is engaged with a healthcare professional.
It’s important to note that the nurse’s only concern is the needs of the injured worker. The triage nurse does not make any compensation determinations.
Thanks to this innovative program, both the employer and insurance company are aware of the situation with accurate information. The claims can be more efficiently addressed, keeping costs down and potentially lowering your company’s experience modification rate (EMR).
Since all of the calls are recorded and available for future review, a nurse triage program discourages false claims and potential fraud. Injured employees are notified at the outset that the call is recorded and creates a basis of the details so that any changes in the details made later can be effectively challenged.
Ultimately, this kind of program is a major win for employers, employees, and the insurance company. Plus, there are additional benefits:
- It’s free, which keeps the cost of living down
- It provides appropriate medical advice for employees
- It eliminates employer involvement
- It may assist your employees to return to work faster
- It improves morale by showing employees the company cares about their well-being
- It reduces lag time in reporting (long lag times have been shown to increase claims costs)
- There is the potential to reduce direct and indirect bottom-line costs to employer
Since the introduction of this program, we have noticed a huge improvement in the way claims are handled, a decrease in the number of claims that are reported during the year, and a tremendous drop in cost.
It’s important to remember in an unmanaged situation, the workers’ compensation system is set up so that injuries are treated without any regard to appropriate expense. With a phone-based nurse triage program, you have the ability to stem these expenses and reduce the number of claims while at the same provide appropriate care. Employees receive immediate access to experienced, reliable medical professionals; avoid time-consuming visits to emergency rooms or clinics and unnecessary testing or procedures; are able to return to work much quicker; and have confidence that the recommendations provided are intended to achieve the best possible post-injury care.
Has your broker spoken to you about a nurse triage program for your business? If not, we are here to answer your questions, contact us today.
