Employers today are combating rising health care costs and looking to identify additional ways to increase efficiencies and better manage the health of their employees. A unique opportunity lies in the process of integrating workers compensation and disability insurance from a health care delivery standpoint.
Employers who utilize a consolidated claim intake process for managing both workers compensation and disability claims may be able to ensure a more consistent process and better employee care, by assuring treatment protocol is managed in the same way regardless of the initial reason for the claim. They both represent a health care claim, right?
Same Injury, Same Claims Process
For example, a workers compensation TPA may receive a claim for a knee injury at the workplace. In many cases the employee will be directed to receive specific diagnostic testing to confirm the injury and process the claim. They may also be referred for follow-up care. The same is true when an employee submits a non-occupational claim to a disability vendor to process a similar knee injury received during a personal holiday. However, the two claims may be processed in very different ways, which may result in the employer and employee incurring a more expensive cost for the same procedure and follow-up care.
An integrated process can reduce or eliminate this inconsistency, assuring that employees are always directed to the most cost-efficient and applicable care for their needs, regardless of the circumstances of the injury or illness.
Spot Related Health Issues
In addition, such integration provides an opportunity to address additional employee health risks by identifying co-morbidities during the claim process. For example, an employee suffering from chronic back pain may also be overweight and/or suffer from diabetes. Forward-thinking organizations are using integrated claim in-take and data management to refer these employees to services offered through the company wellness program.
Studies have shown that employees are more likely to engage in treatment or wellness support when they are in the midst of a health event.