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How a Nurse Case Manager Can Help Reduce the Cost of Workers’ Compensation Claims

by Christine HorvathFebruary 22, 2019 1:38 PM

What do you do when a worker gets injured on the job? It’s important to make sure your employees are protected in the case of a job-related injury, while also making sure that your business is protected. 

Every company is susceptible to workplace injuries. In 2017, the U.S. Bureau of Labor Statistics reported about 2.8 million nonfatal workplace injuries, ranging from slips, trips, and falls to muscle strains.

As an employer, finding ways to contain costs in all areas of your business are crucial, but there is a fine line between saving money and ensuring the health and recovery of your employees in these situations. One way to set yourself up for the best possible result of a workers’ compensation claim is to utilize a nurse case manager.

 A nurse case manager can help reduce the cost of worker’s compensation claims.

Role of a Nurse Case Manager in Workers Compensation

A nurse case manager helps address the medical needs of your employee, while keeping open communication between all parties involved. According to mPower by Mitchell, a group of technology leaders and insurance industry experts, “Engaging a nurse case manager on a claim can save an average of $6,100 in medical and indemnity costs, resulting in an 8:1 ROI.” 

Group Management Services (GMS) understands the importance of having a nurse case manager who is closely involved in moving claims forward while focusing on your employee’s health and recovery. Here’s how our in-house nurse case manage can reduce costs:

 

GMS In-House Nurse Case ManagerOthers
Provides prompt medical review of complicated industrial injuriesTake a “wait and see” approach
Fast tracks claims on Day One to an in-house case manager dedicated toward a positive claim resolutionEmployees are misinformed by unqualified outside sources
Spots “transitional duty opportunities” for a swift return to workIncur replacement labor costs
Reduces likelihood of attorney involvementOpen themselves up to “Ambulance Chasers”
Focus on improving morale and encouraging positive outcomes for all partiesPoor company morale leading to “copycat” claims
Collaborates team approach in working hand-in-hand with GMS claim examinersPotential for errors in paperwork without a qualified professional
Corresponds with medical personnel to improve efficiency of treatment in identifying all work-related conditionsDelayed care drives costs and increases frustration
Controls medical tests and coordinates care to improveLate diagnosis can lead to less efficient treatment and delayed recovery
Identifies red flags for fraud and potential Rx abuseIncreased costs and opiate addiction risks
 
As you can see, when you have someone closely involved to moving the claim forward and focusing on your employee’s health and recovery, everyone wins. Helmsman Management Services, a subsidiary of Liberty Mutual Insurance, compiled the injury data from over 40,000 claims and found that claims involving a nurse case manager had:
  • 16 percent lower future medical costs
  • 15 percent lower overall claim costs
  • 12 percent faster claims resolution
In addition to cost savings, when you partner with GMS for workers’ compensation claims management, you’ll be able to leave the details to us. GMS will oversee the process of claims management and work closely with carriers to ensure your best interests are always at the forefront. We’ll help with claims investigation, claims certification, hearing representation, and merit rate predictions, so you can keep the focus on growing your business.
 

More Than a Risk Management Company

An in-house nurse case manager is just one of the ways GMS can help save you time and money when it comes to the administrative functions of running your business and managing your employees. When you partner with GMS, our experts can assure you have everything covered when it comes to payroll, human resources, risk management, and employee benefits. Contact us today to learn more. 

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