Utilizing a Nurse Triage Program

影响工人索赔费用的最重要因素之一是工人接受医疗所需的时间. 员工必须尽快得到护理，以减少受伤的影响. A way to help with this issue is to implement a nurse triage program. A nurse triage program allows employees, 雇主或双方都要叫一名工伤赔偿护士来评估受伤情况，以确定雇员需要的护理水平. If the employee calls on their own, 分诊护士接受第一份受伤报告，并立即将信息提交给所需的各方(例如.g., employer and insurance company).

立即提供护理可以防止员工因受伤而失去工作日. Companies also benefit from the reduction in workers’ compensation claim costs, 潜在地降低经验修正率并接收有关损伤的准确信息. Review the guidance in this article to learn more about nurse triage programs.

What Is Nurse Triage?

护士分诊是一个项目，企业与医疗服务提供者签订合同，专门为员工设立热线电话，询问他们的工伤或疾病. 这些项目通常已经由雇主使用的保险公司设立，用于工人赔偿保险. 允许员工与护士接触，以获得工人赔偿索赔，这对治疗是有益的. It can also help with quicker claim reporting.  

员工可以在一天中的任何时间拨打护士分诊热线报告受伤或疾病. 接电话的护士将通过一系列问题来收集工人赔偿要求所需的信息. Once the information is taken and the employee has been assessed, the nurse will determine the severity of the injury or illness. Then,  护士将向员工提供美高美集团4688如何处理受伤的建议，或将他们转介到他们受伤所需的护理级别.

In a nurse triage program, nurses assist with claim management. They gather the information and complete the first report of injury. Once the information is obtained, the nurse will inform the necessary parties concerning the employee injury (e.g., employer, supervisor, physician and insurance claims administrator).

How Nurse Triage Can Benefit Claims

护士分诊计划可以通过以下方式使有工人赔偿要求的公司受益:

• Workers’ compensation claims and costs
• Lost time
• The company’s experience modification rate

这些项目还为员工提供专业的医疗保健指导，从而使员工受益.

通过使用护士分诊计划，工人的赔偿成本可以降低，因为员工越早得到工人赔偿索赔的治疗, the less the claim could potentially cost.. If a workers’ compensation claim is reported a week late, a Hartford Research Study found that it can increase the claim cost by 10%. 

In addition, 迟报工伤和疾病也会影响索赔的诉讼. According to the National Council on Compensation Insurance (NCCI), the later an employee reports an injury, the higher the likelihood of litigation for that claim. The NCCI has found that 22% of claims reported within 10 days are litigated. If the claim is reported more than 31 days after the injury occurred, about 47% of those claims are litigated.

When employees report injuries in a timely manner and receive treatment sooner, their likelihood of losing time away from work decreases. Furthermore, 当员工不旷工或有大量医疗费用时，受伤率就会降低. If the injury rate and claim costs are reduced, a business’s experience modification rate also decreases. 经验修正率是保险公司分配给反映其工人赔偿索赔历史的公司的比率. If a company’s experience modification rate is low, it reduces its workers’ compensation insurance premium costs. 相反，如果费率高，工人赔偿保险费的成本就会上升.

护士分诊计划还为员工提供专家健康指导. 对护理有积极体验的员工比那些有消极体验和心态的员工康复得更快. Employee morale is also affected by how employers take care of their employees. 一家提供快速和方便的护理的公司可以帮助工人加速康复并保持良好的精神状态. 

Considerations for Nurse Triage Programs

Even though a nurse triage program offers many benefits, 当雇主建立一个项目时，有一些考虑因素应该意识到.

护士分诊程序只处理医疗问题，不处理索赔过程的任何其他方面. 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. Even though medical treatment could benefit the employee, it does not mean the claim will close sooner. Therefore, 护士和理赔员之间的有效沟通是必不可少的，当利用护士分诊程序，以实现有利的结果索赔.

Not all insurance providers utilize nurse triage programs. 一些保险公司可能会寻求保持对索赔过程的完全监督, 因此，护士分诊计划的实施可能会降低他们的控制水平. 这可能是由于护士对工人赔偿的规章制度不熟悉, leading to complications in the claims process. Therefore, 对于企业来说，与他们的工人赔偿提供者沟通，以确保他们与护士分诊计划的兼容性是至关重要的.

Conclusion

Depending on the business’s needs and its workers’ compensation insurer, a nurse triage program may be beneficial. 重要的是要了解程序是如何工作的，以及程序的好处和注意事项是什么. 最重要的是，这取决于什么对使用它的公司最有效. 

本报告并非详尽无遗，任何讨论或意见也不应被视为法律建议. 读者应联系法律顾问或保险专业人士以获得适当的建议. © 2023 Zywave, Inc. All rights reserved.