Nurse Triage Process Draws Increased Scrutiny: Top [2018-07-10]

Companies that are primarily providers of workers’ comp nurse triage services may have an incentive to recommend self-care for injured employees rather than an in-person or telemedicine visit to a doctor, according to one cost-containment company.

But the seemingly cost-saving strategy can backfire and actually increase costs, an official with Sedgwick said in a blog post last month…


David Donn, chief executive officer of San Francisco-based consulting firm Donn & Co., said nurse triage can be a useful early-intervention tool, but its effectiveness should be monitored.

“Ultimately the employer’s own data and experience should be the deciding factor on effectiveness — not necessarily the pool of data that the TPA or managed care company provides,” Donn said.

The triage program should be benefiting the employer rather than merely serving as a “convenient source of self-referral for the TPA or managed care company to steer business to their other loss-control products like UR, field or telephonic case management,” he said.

Another factor to consider is how much experience the triage nurses have with the client’s specific industry.

Donn said that employers who are interested in nurse triage should test it on trial basis, checking results
periodically and making needed adjustments…

WorkCompCentral – Nurse Triage Process Draws…