Nurse Triage: An Effective Weapon in Fighting New York Workers’ Compensation Insurance Costs

Posted by John Cofini on Tue, Sep 04, 2012 @ 05:07 PM

When one of your employees gets injured on the job, a quick decision needs to be made about what should happen next. Do you send the employee to the emergency room? Should you send them home to "wait and see" if the pain goes away?

The usual course of action is for the employee or the supervisor to determine the level of medical care needed. And since neither one has medical training, they normally choose the highest level of service available “just in case.” But there’s another option for New Jersey and New York employers – one that can significantly reduce the overall costs of a New York workers’ compensation insurance claim.

Nurse triage is a service more and more employers are using – often through their business insurance provider – to control the cost of medical care in New York workers’ compensation insurance claims. Basically, it involves the use of experienced nurses, clinical guidelines and technical medical software to determine the appropriate level of medical care an injured employee needs. And it’s most effective when utilized immediately after a workplace injury, before the injured employee seeks medical care that could be too little or too much.

A nurse triage service offers trained nurses 24/7 to assess an employee’s injury over the phone. The top services use well trained nurses and highly technical medial software to determine the acuteness of the employee’s symptoms and recommend the most suitable level of care. By advising the injured worker of the most suitable level of medical care, costly trips to the emergency room can be avoided and unnecessary trips to the clinic can be reduced.  Also, trips to the clinic for the injured worker means they can generally obtain appropriate treatment sooner than they would if they had to wait in an emergency room unnecessarily.

Protecting your bottom line

In addition to reducing costs by getting the employee the proper level of medical care, using a nurse triage service can improve your bottom line in other ways: 

  • Creating a higher level of self-care, helping to lower claim volume
  • Lowering OSHA reportable injuries, which can be a bi-product of unnecessary medical claims
  • Increasing the number of in-network claims
  • Reducing lost work time and improving productivity
  • Increasing employee morale with trained nurse available immediately
  • Providing immediate incident tracking, thereby reducing the occurrences of fraud
  • Controlling medical treatment day and night for employers who have varying work shifts
  • Identifying life threatening situations and other serious conditions that aren’t immediately recognized by employees who are injured 

How do you choose the right service?

When choosing a nurse triage service, you should look for triage providers that have verifiable certifications and medical accreditations. Also, verifiable competency, including a variety of triage experience and good references are vital.  Any service you consider should be accredited by the Utilization Review Accreditation Commission (URAC). If the triage company has URAC Health Call Center accreditation, the company is performing in accordance with national standards.

With New York workers’ compensation insurance claim costs on the rise, you need every advantage you can get to control costs and protect your profits. Using a nurse triage service is an effective tool you can use to reduce claim costs, avoid litigation, and reduce instances of fraud. And it’s also a good way to give yourself and your employees some peace of mind.

Want another tip for controlling New York workers’ compensation insurance costs? Download our free report about New York Safety Group options.

Tags: New York workers’ compensation, new york workers’ compensation costs, New York work comp, New York nurse triage