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Telephonic Triage for Workers Comp – Is It Really Worth It?

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Telephonic Triage for Workers Comp

Is Telephonic Triage in WC really worth it in most instances?  I had a great conversation with an old Workers Comp friend that had begun to sell triage service by phone for claims. As he mentioned, safety measures occur up to the time of an accident. Workers Comp triage can come into play a few seconds after an injury.

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BTW, my definition of Workers Comp phone triage is having a nurse become involved telephonically immediately after the occurrence of an accident. Triage by a nurse can also be in-person. A plant nurse is a great example. However, if an employer is not large enough or the profit margins are too close, phone triage for Workers Comp may be a great option.

Telephonic triage can actually cut the reportable incident rate as certain injuries that can be self-treated may not require a work stoppage or a doctor visit. In most cases, a first report of injury may not necessarily need to be filed. You may want to check with your insurance carrier or TPA before deciding what constitutes a reportable injury.

I actually established a small phone triage nurse case management department a few years ago for state employees. It worked well. Controlling the medical will always reduce Workers Comp costs. Check out the keys to workers comp reduction from one of my old blog posts.

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In this economy, the one area that I would say is a negative is the upfront cost. Convincing senior level management may be tough as the cost savings will not be realized for months to come as your E-Mod or for self insureds – the Loss Development Factor is a lagging system. As I pointed out in this blog post, Workers Comp results are delayed for sometimes up to three years.

A telephonic nurse company was doing a great business in the southeast 10 years ago. It is no longer in business. The main reason was its competition. There were almost no competing companies in the area. Convincing carriers, employers, and TPA’s of a new type of service is a very tough service to sell for an extended period.

My overall answer is a definite yes for telephonic triage as it enhances the immediacy of responding to an injured employee’s claim very quickly. As with any service, there are companies that perform at a higher level than others. I rarely make company recommendations on this blog.

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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