Many interested stakeholders find themselves looking for a quick “win” by making a change to control workers’ compensation costs. The task may seem daunting, but there are things one can do to implement a policy decision that will have an immediate and noticeable impact on the direction of a program. Now is the time to look for those wins and implement change to reduce money spent on a program.
1) Consider Using Medical Bill Cost Containment
This change can be done internally or through a service provider to better monitor and review money spent on the medical aspects of a workers’ compensation program. It can also pay immediate dividends to programs of all sizes that free up money that can be used to resolve troublesome claims. Steps to use this tool can include:
- A close review of all procedure codes when evaluating medical claims within a participating medical network. Look for opportunities to drive savings;
- Work with consistent medical providers to establish lower fees for common medical services. Areas where this is usually employed, are services typically used to care for an injured employee, such as physical therapy and diagnostic scans and studies; and
- Collaborate with specialists on the need for medical care and treatment. This should include peer review to help mitigate unnecessary medical spending.
Using cost-containment strategies takes courage and a willingness to be aggressive. When done correctly, there will be an immediate reduction in money spent on the medical aspects of a claim while at the same time ensuring the employee receives proper medical care.
2) Never Let Claim Files Collect Dust
Claim files that collect dust are the files that create problems. These include missing filing deadlines, allowing for prolonged periods of work, and excessive medical care. Steps should be taken within a claim team to ensure all files are being reviewed constantly and steps are being taken to drive them toward closure.
- Plan Ahead: Every claim handler should be asking, “What will happen next” when it comes to their files. This will allow the claim handler to anticipate better what will occur and what needs to be done to mitigate exposure;
- Encourage Pro-active Communication: An effective claim handler should never be waiting for someone to call them. Instead, a claim handler should reach out to employer representatives and defense counsel to ensure they are on top. It also helps improve lines of communication with stakeholders who are not willing to share; and
- Gather all Necessary Information: An effective claim handler is like a sleuth – always looking for information. Stay curious!
Encouraging members of the claim management team to ask questions and communicate and reduce program costs by moving files forward. Get ready to start closing claim files.
3) Implement Telephonic Nurse Case Management
There are countless benefits to adding telephone nurse case management, where the cost of adding it saves money in the long run. It is also a tool that can be used to improve workplace morale and better direct post-injury medical care. This tool will allow any claim management team to stand out in terms of providing best in class services. Now is the time to consider adding it to your workers’ compensation program.
- Managers and supervisors can assess the nature and extent of a non-life-threatening work injury. This is based on having access to a trained medical professional to make an initial diagnosis, assist with post-injury care, and better direct additional medical intervention if required;
- Allows managers and supervisors to address workplace injury with the confidence of having a skilled medical professional assist. Access to these programs is also 24/7/365; and
- Allows for better documentation of a work injury to ensure the claim is reported promptly and accurately.
Now is the time to consider adding telephone nurse case management to your program. While there is a cost, it will drive better outcomes and move the employee back to work more quickly.
There are many things interested stakeholders can do to improve their workers’ compensation programs and immediately reduce program costs. These steps include focusing on medical cost containment and constantly reviewing files. It should also include implementing a telephonic nurse case management program to ensure employees injured on the job receive the best response possible. Taking these steps will drive program efficiency and reduce program costs.
Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is the founder & lead trainer of Amaxx Workers’ Comp Training Center, which offers the Certified Master of Workers’ Compensation national designation.
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