Nurse triage: TLC for your ailing workers’ compensation costs

By Higginbotham on October 14 , 2014


When workplace accidents strike, you need to make quick decisions about your next steps. Should you send your employees to the emergency room or to a primary care doctor? Or should you just send them home to see if the situation resolves with a little rest?

Unfortunately, the people that usually make the “next step” decision – the injured employee or a supervisor – don’t have the medical training to know what the appropriate level of care is. That can too often lead to excessive costs when they choose a higher level of service than necessary just to play it safe.

On top of the potential medical costs of that decision, you need to do everything possible to prevent fraud or a lawsuit. That’s why more and more businesses are outsourcing that decision to a nurse triage service.

What is a nurse triage service?

Nurse triage services use highly trained and experienced nurses, strict clinical guidelines, and special software to assess an injured worker’s symptoms and determine the appropriate level of care. They can be an invaluable front-line defense against out-of-control medical costs when implemented immediately following an injury. And with these services, trained nurses are on-call 24/7 to evaluate workplace injuries over the phone – whenever they happen.

Nurse triage services can help employers control costly hospital emergency room treatment or unnecessary clinic visits. And they make sense for injured workers because they can generally get appropriate treatment faster than they would if they were waiting in an emergency room.

The benefits don’t stop there.

On top of helping reduce medical costs, using a nurse triage service has other benefits including:

  • Increasing the percentage of self-care and reducing claim volume
  • Reducing OSHA reportable injuries by avoiding unnecessary medical claims
  • Making sure more claims are handled through your medical provider network
  • Decreasing the amount of time an injured employee is off work and increasing productivity
  • Boosting an injured worker’s morale by having a trained nurse immediately available
  • Providing crucial documentation of incidents, helping to reduce instances of fraud
  • Providing round-the-clock control of medical treatment for employers with multiple work shifts
  • Identifying potentially serious and life threatening injuries not recognized by the injured worker

Where do you start?

Many companies use nurse triage services provided by their insurance carriers. But whatever provider you choose, you obviously want them to be competent and experienced, with the appropriate references, accreditations, and certifications. Make sure the service you consider is accredited by the Utilization Review Accreditation Commission (URAC). And, if the provider has a URAC accreditation for Health Call Center, they have to meet strict national standards.

Using a nurse triage service can be an ideal solution for reducing claim costs, cutting down on fraud, and staying out of legal hot water. And it gives your injured workers some valuable peace of mind at a stressful time. To find out more, talk to the Texas workers’ compensation insurance experts at Higginbotham.

Tags: Business Insurance


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