Work Comp
e-Triage has combined an internet-based rules engine with the latest academic research into injured worker medical, psychosocial and economic risk factors to create a system which automates and standardizes the three-point contact. The system integrates and compares data gathered from Employee, Employer and Provider, directly impacting the recovery process.
While most companies do an excellent job of completing the three-point contact, the quality of the information gathered during those interviews varies from company to company. Analyzing the data from the employee, employer and provider offers a challenge that is critical to a timely and effective return to work.
The immediate benefit of the e-Triage process is that all of a payer’s employees, both new hires and experienced adjusters alike, are prompted to ask the key claim-specific relevant questions and gather that information in a consistent and well-documented fashion.
At the completion of each contact, the system compares information gathered from the intelligent scripted interview to rules, based on scientific research and the client’s own business practices, to recommend an action plan designed to mitigate the risk factors and resolve any issues identified on the claim. The application then delivers the case electronically to the appropriate professional:
- Claims Adjustor – alerted to potential problem claims early on with specific areas identified with recommendations for action, resulting in better reserving and lower indemnity costs.
- Medical Case Manager – acts on medical issues and action recommendations to work through the identified deterrents to recovery. Recommendations summarize musculoskeletal “best practices” to achieve a sustained recovery and return to work.
- Return to Work Specialist - Focuses on return to work issues. Facilitates ergonomic assessments and adjustments to the work site. Coordinates return to work and transitional work opportunities.”
e-Triage reviews are entirely objective. The results of evidence-based research and client business rules are applied consistently to every case. Numerous prospective randomized trials have proven that the absence management concepts of e-Triage result in productivity improvement, reduced absenteeism, and employee retention, greatly reducing health and productivity management costs for employers. Recent studies have proven that absence management programs like e-Triage can reduce time off work by more than 50%.
