How To Control Workers' Compensation Costs

How To Control Workers' Compensation Costs RETURN TO WORK Modified duty, transitional duty, and light duty, describe putting an injured employee back to work before the injured employee is fully capable of returning to regular work. INJURY OCCURS MODIFIED DUTY REDUCING COSTS INJURY OCCURS MODIFIED DUTY REDUCING COSTS An employee with a lacerated hand would not be capable of returning to job where two hand lifting is required. The employee should be placed on modified duty. A modified duty program benefits the employee Despite the injured hand the employee is capable of answering the phone; checking deliveries, counting inventory, etc. who remains active and compensated. Disability costs paid by the insurer are reduced, lowering the cost of the workers' cor ensation claim. SAFETY PROGRAM The fastest and easiest way for an employer to reduce the frequency of workers' compensation claims is through the instigation and continuation of a strong safety program. APPOINT A SAFETY MANAGER ELIMINATE JOB HAZARDS Part of the safety program should include written rules The responsibilities of the safety manager are to motivate, educate, and train employees. It is the safety manager's responsibility to encourage employees to operate safely. and procedures to indoctrinate new employees, require periodic inspections, investigate accidents, provide first-aid care and have an effective return-to- work program. CREATE A SAFETY COMMITTEE Safety Specialists and/or a Safety Committee should be available to keep safety at the forefront at all times. MANAGEMENT COST CONTROL With the high cost of medical care, controlling and managing the medical care provided to an injured employee is essential. ONSITE EVALUATION CASE MANAGEMENT COST CONTROL A triage or worksite nurse evaluates injuries immediately after they occur and arranges for the injured employee to receive the proper level of medical care, whether it is first aid, an A nurse case manager is involved in the claim if the injured employee will require time off and cordinates medical care, facilitates medical treatment, assists the employer and employee in complying with return to work options, and arranges rehabilitation services, if needed. Having cost control services in place and ready to use including medical fee schedule reviews, utilization reviews, peer reviews and pharmacy benefit managers. clinic or a emergency skilled specialist. FRAUD PREVENTION Every employer should have a fraud prevention program. Every employee should know that the employer considers fraud a serious crime and prosecutes it thoroughly. 25% OF ALL WORKERS' COMPENSATION CLAIMS CONTAIN AN ELEMENT OF FRAUD Mlu WHAT IS FRAUD? Fraud can be committed by workers, who feign an injury, collect disability payments while working for someone else, or simply refuse to go back to work. Fraud can also be committed by employers who fail to pay for workers' compensation insurance, or who misrepresent their payroll in an attempt to avoid workers' compensation premiums. Fraud can also be committed by clinicians who misrepresent their treatment. %24 EHANCED CLAIMS inflated injuries phantom injuries FAILURE TO PREVENT FRAUD CAN ADD bogus lawsuits illegal kickbacks 10%-20% fake clinics TO WORKERS' COMPENSATION COSTS CID Review © 2013 CID Management. Powered by CID Management. cid management %24 %24