Medical management is a well-established cost control technique for workers’ compensation. The use of nurse case managers to provide oversight of an injury claim facilities the medical treatment, speeds the recovery process and shortens the time until the injured employee can return to work. The benefits of nurse case management are so potent, that almost all workers’ compensation programs now include nurse case managers.
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Top Notch Nurse Case Managers Create Best Return on Investment
Due to the positive impact of nurse case managers, there are now numerous medical management companies providing the service. Every one of the medical management companies providing nurse case managers can save the employer money. However, there is a difference between the best of the medical management companies and all the rest. Selection of the company providing the top-notch nurse case managers can be the difference between a return on investment of 3 to 1 or a return on investment of 10 to 1.
To select the medical management company with the best nurse case managers, look for the following attributes:
- The experience level of the nurse case managers is key. While a nurse case manager with 5 years’ experience can be excellent at what he/she does, a nurse case manager with 25 years’ experience will probably be better. Therefore, ask the medical management company you are considering:
- What is the average number of years of nursing experience for the nurse case managers?
- What is the average number of years of nurse case management experience for their nurses?
- What is the average tenure the nurse case managers have been with your company?
- A large support network is necessary. While nurse case managers have extensive training, like doctors they are not experts in every medical specialty. As more than 25 different medical specialties can be involved in different types of work comp claims, the medical management company needs to have contracted physicians available to assist the nurse case manager in all specialty areas of medicine.
- The medical management company must have nurse case managers in the vicinity where your company experiences work comp claims. A great nurse case manager in another city or another state who does not know the local medical providers and medical facilities will be less effective than the local nurse case manager.
- The nurse case manager should not only be local, they need to be experienced with the medical providers. An experienced nurse case manager can quickly tell you which medical specialists get good results and which ones do not.
- The field nurse case managers that are local to your facility also cost less over the long run. If you are paying a nurse case manager who is more than an hour away from a facility, a disproportionate amount of the service bill will be for driving time, plus mileage.
- The nurse case managers need to be willing to share with the employer not only what is in the medical reports, but their conversations with the injured employee, medical providers and others. This provides insight into what the claimant and medical provider are saying and thinking.
- The nurse case managers need to be willing to share with you information that is “off the record”. This includes observations and insights gathered from the actions of the employee or medical provider.
If you have multiple locations, larger medical management companies will have better geographical spread, are more likely to have more experienced nurse case managers and will have more contract physicians covering more specialties. For assistance in selecting medical management companies with the best nurse case managers, please contact us.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers’ compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers’ compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:RShafer@ReduceYourWorkersComp.com.
Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.
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