Medical costs CAN be controlled or contained using a variety of strategies. Third-party administrators and insurance company claims administration teams offer various services to reduce medical costs.
Medical cost control is fee management achievable by either:
- reducing the number of treatments,
- reducing the cost of treatments, or
- purchasing premium services.
This last option, costing more initially, reduces the length of time an employee is out of work.
The services available to reduce medical costs include:
- Injury Triage
- Preferred Provider Organization
- Telephonic Nurse Case Management
- Field Case Management
- Mental Health RNs
- Chronic Pain Programs
- Aging Workforce Programs
- Peer Review/Utilization Review
- Medical Directors and Medical Advisors
- Independent Medical Evaluations
- Durable Medical Equipment
- At-Home Recovery Services
- Medical Bill Review
- Chiropractic Care
The employer must understand how these services work and the value they bring to the company’s unique workers’ compensation situation. It is not a “one size fits all” solution for cost reduction. For example, telephonic nurse case management incurs certain fees, requires the nurse case manager to hold certain licenses depending on jurisdiction, and is used when claims are complex or in lost time claims where length of time out of work is disproportionate to the injury.
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