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You are here: Home / Medical Cost Containment / Getting the Best Initial Care for Your Injured Workers

Getting the Best Initial Care for Your Injured Workers

January 4, 2011 By //  by Kelly Haile, RN, CCM, WCCM Leave a Comment

As an employer, you want your injured employees to get the best care available when they are hurt. You also want to find healthcare providers who understand your company’s specific goals, needs, and possibilities. And you want them focused on the bottom line as well. A very tricky balancing act – but a necessary one!

 

 

How can you locate and identify a good initial healthcare provider? Here are a couple of suggestions from a case management nurse who has been around the block a few (million!) times: (WCxKit)

 

 

  1. For your initial evaluation and treatment, a great choice is an experienced Occupational and Environmental Health Physician (OEM). This is a specialty of physicians who evaluate the interaction between work and health. An Occupational Health doctor should be familiar with work operations, return to work procedures, workers compensation laws in your jurisdiction, and many other related topics. Please note:Just because the local clinic calls itself an “Occupational Health Clinic” don’t assume the doctors are Occupational and Environmental Medicine Physicians!

 

 

  1. As you are selectingor reviewing your panel provider for occupational health, CALL the center and speak to the administrator. Set up a tour. Meet with the doctor(s). Ask about their specialty and experience. You are putting your employees’ health and your money into their hands, so go and check them out. Trust me — if the doctors won’t play nice with you, they certainly won’t play nice with your injured workers.

 

 

  1. If you’re not sure where to find a qualified OEM doctor, check out the website for the American College of Occupational and Environmental Medicine, www.acoem.organd click on “Find a Doctor.”

 

 

  1. If you are in a locationwhere there is no qualified OEM nearby, talk with your nearest occupational health center’s medical director and make sure he or she is familiar with your state workers compensation laws, your company’s policies regarding post-injury care and return-to-work, and that the doctor is willing to keep in close contact with you during treatment of your injured employee. Feel free to send over your own post-accident form for the doctor to complete, if you don’t like the form the center provides. You’re paying for this service – make it work for you!

 

 

  1. PAs and NPs and DOs, oh my!Yes, there are too many initials in medicine. Let’s see try to clear up some you might encounter at your Occupational Health Center.

 

 

PA = Physician Assistant

A PA has completed an educational program lasting approximately 26 months; is state-licensed and certified by examination, and must complete continuing education regularly. A PA can prescribe medications, and must work under the supervision of a physician.

 

 

NP = Nurse Practitioner

An NP has completed graduate education as a Nurse Practitioner beyond the Registered Nurse program, either to the master or doctorate degree level; is state-licensed and nationally certified by examination, and must complete regular continuing education. A NP can prescribe medications and, depending on the regulations of their state may or may not function under a physician’s direction. Some states allow NPs to set up private practices without physician supervision. Other states require some collaborative agreement with a physician. (State Requirements)

DO = Doctor of Osteopathy

Yes, they are “real doctors.” To generalize greatly, DOs have the same scope of practice as MDs, though there are differences in their training and treatment techniques. DOs are licensed to practice the full scope of medicine throughout the United States.

 

 

Overall, we recommend good old fashion COMMUNICATION! If you or a supervisor, adjuster, or case manager isn’t comfortable calling your healthcare provider to touch base about a tricky case, then you’re using the wrong facility. (WCxKit)

 

 

Remember, if you are in a Employer-Choice or Panel state, this is YOUR CHOICE. Make an informed decision. Be comfortable with your choice. If you’re in an Employee-Choice state, it’s still a good idea to have an Occupational Health center you are comfortable with and use. Often, you’ll end up sending your injured worker there, at least for an initial evaluation and quick treatment.

 

 

Starting with the best possible healthcare provider gets your claim off on the right foot (or shoulder, back, knee . . .). Do your homework and you’ll be ready!

 

 

Author: Kelly Haile, RN, CCM, WCCM is an experienced Nurse Case Manager who advocates working closely with each employer to refine their Workers Comp program to provide better post-injury care, excellent medical case management and timely communication. We provide services primarily in the PA, NJ, DE and MD areas. You can reach Kelly in her role as Director of Case Management at NursePartners, LLC, by phone at 610-323-9800, fax 610-323-8018, Email: [email protected].


WORK COMP CALCULATOR:
http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR: http://www.LowerWC.com/transitional-duty-cost-calculator.php

 

WC GROUP: http://www.linkedin.com/groups?homeNewMember=&gid=1922050/
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.


©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
[email protected].

 

Filed Under: Medical Cost Containment, Medical Issues, Risk Management Tagged With: Communication, Medical Coordination & Cost Containment, Medical Issues, Nurse Case Manager, OEM

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