利用护士分类程序

One of the most significant factors that affect the cost of workers’ compensation claims is the time it takes for a worker to receive medical treatment. It is essential that employees receive care as soon as possible to reduce the effects of an injury. 解决这个问题的一个方法是实施护士分诊计划. 护士分诊计划允许员工, the employer or both to call a workers’ compensation nurse to assess the injured in order to determine the level of care the employee needs. 如果员工自己打电话, the triage nurse takes the first report of injury and submits the information to the required parties immediately (e.g.、雇主及保险公司).

Providing care right away can prevent employees from losing workdays due to injury. 企业还受益于工人索赔成本的降低, potentially lowering experience modification rates and receiving accurate information about the injury. 回顾本文中的指导，了解更多美高美集团4688护士分诊计划的信息.

什么是护士分诊?

Nurse triage is a program where a business contracts with a medical provider to set up a hotline specifically for employees to call in about their workers’ compensation injuries or illnesses. These programs are often already set up by the insurance company the employer is using for workers’ compensation coverage. Allowing an employee access to a nurse for their workers’ compensation claim can be beneficial in treatment. 它还可以帮助更快的索赔报告.  

Employees can call the nurse triage hotline any time of the day to report an injury or illness. The nurse who answers the call will go through a list of questions to gather the information needed for the workers’ compensation claim. 一旦信息被获取，员工被评估, 护士将确定受伤或疾病的严重程度. 然后,  the nurse will provide the employee with advice on what to do with the injury or refer them to the level of care they need for their injury.

在护士分类程序中，护士协助索赔管理. 他们收集信息并完成第一份受伤报告. 一旦获得了信息, 护士将告知有关员工受伤的相关方(如.g.、雇主、主管、医生和保险理赔管理人).

护士分诊如何有利于索赔

A nurse triage program can benefit companies with workers’ compensation claims by reducing:

• 工人赔偿索赔和费用
• 失去的时间
• 公司经验修改率

Such programs also benefit employees by providing them with expert health care guidance.

Workers’ compensation costs can be reduced by using a nurse triage program because the sooner an employee is treated for a workers’  compensation claim, 索赔的潜在成本就越低.. 如果一个工人的赔偿要求报告晚了一个星期, 哈特福德的一项研究发现，它可以使索赔成本增加10%. 

除了, late reporting of workplace injuries and illnesses can also influence the litigation of a claim. 根据国家赔偿保险委员会(NCCI), 后者有员工报告受伤, 诉讼的可能性就越高. NCCI发现，在10天内报告的索赔中，有22%被提起诉讼. 如果索赔是在伤害发生后超过31天报告的, 其中约47%的索赔被提起诉讼.

当员工及时报告受伤情况并得到治疗时, 他们失去工作之余时间的可能性降低了. 此外, the injury rate lowers when employees do not miss work or have substantial medical costs. 如果伤害率和索赔费用降低, 企业的体验修改率也会下降. The experience modification rate is what insurance providers assign to a company reflecting their workers’ compensation claim history. 如果一个公司的经验修改率低, 它降低了工人赔偿保险的保费成本. In contrast, if the rate is high, the cost of the workers’ compensation insurance premium goes up.

Nurse triage programs also benefit employees by providing access to expert health guidance. Employees who have a positive experience with care can heal faster than those with negative experiences and mindsets. 员工的士气也受到雇主如何照顾员工的影响. A company providing care that is fast and convenient can help expedite workers’ healing and keep them in good spirits. 

护士分诊计划的考虑

尽管护士分诊计划有很多好处, there are a number of considerations employers should be aware of when establishing a program.

Nurse triage programs solely address medical matters and do not handle any other aspects of the claim process. The capabilities of a program nurse are not equivalent to those of a claims adjuster; program nurses are unable to perform all the tasks typically carried out by the adjuster. 即使治疗对员工有好处, 这并不意味着索赔会更快结束. 因此, effective communication between the nurse and the claims adjuster is essential when utilizing a nurse triage program in order to achieve favorable outcomes for the claims.

并不是所有的保险公司都采用护士分诊计划. Some insurance companies may seek to maintain complete oversight of the claim process, so the implementation of a nurse triage program could potentially diminish their level of control. This may be due to a lack of familiarity among the nurses with the rules and regulations of workers’ compensation, 导致索赔过程复杂化. 因此, it is crucial for businesses to communicate with their workers’ compensation providers to ensure their compatibility with a nurse triage program.

结论

根据企业的需要和它的工人赔偿保险公司, 护士分诊计划可能是有益的. It is important to understand how the program works and what the benefits and considerations of the program would be. More than anything, it depends on what would work best for the company that would be utilizing it. 

This 工作对比 is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice. ©2023 Zywave, Inc. 版权所有.