Medical Network Management – Active vs. Passive

Health care providers come in all stripes and the quality of care can vary greatly. Relying solely on your insurance carrier or TPA (third-party administrator) network can be costly. These networks are built by finding providers who will agree to a discounted reimbursement rate, in exchange for more referrals. Some of these providers see very few patients in the workers’ compensation system, and therefore, may not understand the role of early return-to-work in the employee’s recovery.

It’s important to work closely with providers that understand the workers’ compensation system and who can support an early return-to-work initiative, such as, Proof:Positive’s Health and Wellness Room model. Provider network discounts are of little value if the treatment regimen drags on…and on. Professionally-managed Health and Wellness Rooms hasten patient recovery and return-to-work by supporting treatment adherence and improving employee motivation.

Proof:Positive can help you identify providers who support an early return-to-work philopsophy. Contact Proof:Positive today.

How Can You Control Workers’ Compensation Costs?

Regardless of the industry you’re in, the best way to control the cost of workers’ compensation premiums is to avoid injury claims. A safe environment, effective safety training, and ongoing programs to promote safe work habits are keys to preventing employee injury.

Once new employees are properly trained to perform their jobs safely, it’s important to maintain safety awareness. In addition to posting safety reminders in common areas, consider holding workshops or hosting safety seminars to talk in depth about the specific issues affecting workers. Providing incentives for good safety records is also a good idea.

In most states, workers’ compensation is “no fault.” That means that on the job injuries are covered by workers’ compensation insurance, regardless of the cause of the accident. In other words, if employees are injured on the job due to their foolish or careless behavior, those accidents are covered by your workers’ compensation insurance. This is why it’s crucial to continually promote safety awareness and safe work habits.

Workers compensation costs businesses over a half trillion dollars. You don’t have to accept your current levels of workers compensation claims or claim costs. Contact Proof:Positive today for a free initial consultation.

Obesity and Healing: Educate your Employees

Obesity is an obstacle that many Americans face, and combining that with the recovery from an injury severely impacts the healing process. Results from a new study in Columbus, Ohio suggest that extremely obese people are more likely than normal-weight people to injure themselves. With this statistic looming, it is vital that we don’t let our injured go on without having the opportunity to change their lifestyle. While prevention is important, education after the fact is essential. Proof:Positive can help employers with new ideas to keep their employees healthy and fit, which can statistically decrease the number of work injuries.

Obesity combined with a simple knee injury, or even a complex surgery, is going to prolong the healing process severely. Obesity falls into an interference with wellness that is not always accounted for by claims adjusters. Although with anti-discriminatory laws you cannot force a diet or weight loss program to those who are overweight or mandate a smoker to quit, studies show that employees and employers favor a program that would educate, and even provide facilities to promote weight management and programs for weight loss. Participants of this survey were asked to disclose to what degree they favor specific health care and work policy blue prints for treating and preventing adult obesity. Seventy-three percent favored a move by health care companies to require obesity treatment and prevention. The same proportion favored beneficiary discounts by employers or health care companies to motivate individuals to maintain or move toward a healthy weight.


Talking With A Doctor – Be Prepared

Visiting a doctor’s office can make your injured workers nervous, impatient, or even scared. They may end up having only a few minutes with their health care provider. Later, they might remember something they forgot to ask, or they may forget what the doctor or nurse said. Being prepared can help them get the information they need. Here are some tips you can give to your injured workers to help them make the most of their doctor visit:

  • Make a list of their concerns, any allergies, and all the medicines, herbs or vitamins they may be taking
  • Provide a detailed description of their symptoms – when they started, what makes them better or worse
  • Bring a notepad – and use it
  • Have a trusted friend or relative to go with them

Make sure that your employee understands their diagnosis, any treatments they may receive, and encourage them to have their provider write down instructions. If they still have trouble understanding the different aspects of their injury, provide them with resources so they can gain the knowledge.

With all the work your company or business has to do, these issues may seem tough to handle. Proof:Positive can handle these issues for you. Proof:Positive can help monitor each injured employee’s case along with providing them with the knowledge and understanding of their injuries. Our Health and Wellness Rooms provide a platform for each injured employee to ask questions and help educate them on their injury and recovery. Proof:Positive has experienced medical staff in each room that can help your injured workers learn how to prevent, and recover from, their injuries. Contact us to see how we can help alleviate the worry and management of your injured workers.

Is Daytime TV Addictive?

Are Oprah or Jerry Springer offering addictive content in their television shows? Is this one of the reasons lost-time workers’ compensation claims can get out of control?

OK, maybe it’s not Oprah’s fault. There are complex psycho-social factors at work when an individual is off work, nursing an injury, with a reduced income. Managing these factors can help keep the individual out of a costly slump (costly to the employee and costly to the employer).

Every day an injured employee is away from work, the likelihood that they will return to work decreases, which is why it is important to have an early return-to-work program (ERTW) in place – to ensure that employees can recover in a safe and supportive environment. By providing access to an ERTW program you take an active role in your employees’ recovery, which benefits both the employee and the employer.

Proof:Positive has successfully integrated Health and Wellness Rooms into employer operations, supporting injured employees and saving companies money by effectively reducing the cost of work comp claims and returning injured workers to work quickly and safely. Contact Proof:Positive to learn how we can help you leave day-time TV for your competitors.

Be Proactive When It Comes to Workers Compensation Fraud

It is much easier to prevent workers compensation fraud than it is to prove it. As an employer it is important to make sure to hire people who have the skills and the character that best fit with your company. Having a sound hiring policy is a good place to start.

Here are a few suggestions on how to be proactive:

  • Hire wisely. Conduct background checks on all applicants, and verify their references.
  • Focus on safety. Making the workplace safer reduces the chance of accidents and the opportunity to fake an injury.
  • Develop a return-to-work policy. Tell job candidates that if they get hurt on the job, the company will work with the doctor to help them return to work as soon as medically possible.
  • Educate, don’t threaten. Explain that workers compensation fraud hurts everyone, not just the insurance carrier. Let employees know that fraudulent claims can force employers to decrease benefits, lay off employees, or go out of business.
  • Adopt a zero-tolerance policy. Make it clear that fraud can carry serious consequences, including termination and prosecution.
  • Stay in touch. Keep regular contact with employees who are off work due to injury or illness. Document each contact or attempted contact. Injured workers who are difficult to contact or who are belligerent may be committing fraud.

This may all sound like a lot to do to keep your company safe. Proof:Positive can help. Let one of our representatives show you how you can protect your business.

Help Your Injured Employees Heal Themselves

Many people injured at work place all of the responsibility of getting well on the doctor. But, what most injured workers do not appreciate is that you have the ability to heal yourself! The doctor is an important part of the process but he only guides you down the right path. It is up to you to walk that path towards recovery and a fast return to work.

“Understanding my injury helped me to recover, and the opportunity that I had here in the Health and Wellness Room to do my therapy and stay active during my rehabilitation is what got me back to work faster than when I hurt my back two years ago.” This is what one of our client’s injured workers told me when he brought in his return to work release papers. He said the information we provided about his injury really gave him an understanding of his injury. He told me that we were motivating him to go back to work. “I was able to walk, exercise, use heat and ice, but best of all I didn’t end up on the couch trying to heal. I feel like I got more attention in the Health and Wellness Room then I did from my doctor or therapist.”

When injured workers rely on the doctor to do all the healing they are prolonging their injury and return to work. They still have to do their therapy and remain active to keep their body from becoming weakened by injury. Help your employees learn about their injuries. This is how you heal with the assistance of a doctor. Knowledge of injuries and ways to prevent them in the future benefit everyone.

Health and Wellness Rooms provide a motivated atmosphere to return to work. Educational materials, therapy beds, ice and heat, medical professional on staff, and a common goal for returning injured workers back to their jobs. Getting off the couch each day keeps employees in work mode, which helps transition back to full duty. Keeping the mind set on returning to work helps the body heal. Exercise gets the blood circulating which helps promote healing. Giving your employees a motivated atmosphere to heal, keep a positive mental attitude and help with recovery.

Workers’ Compensation is Not Insurance

Too many employers believe that workers’ compensation is insurance. Premium rates, experience modifiers, claim reserves…this is not workers’ compensation. This is just a way to finance it.

Workers’ compensation was designed to ensure that injured employees have access to medical care and salary indemnification for work-related injuries. This system was established at a time when some employers maintained hazardous workplaces and abdicated their responsibilities to the injured worker.

Times have changed and our workplaces are much safer. But, many employers still neglect their duty to the injured worker when they do no more than purchase a workers’ compensation policy. Statute requires a system, not a policy.

So what goes into a workers’ compensation system?


Instruments of Recuperation

“Just reading the material made me realize I could lose weight without having to exercise that much,” one of my injured employees said to me the other day. Simple eating changes accompanied by drinking plenty of water every day can improve health, weight, and skin problems – no matter what your activity level. Being idle because of an injury does not mean that you need to have an idle mind. When attending Health and Wellness Rooms injured employees don’t sit and watch television or get lost in the system – they get moving. Whether it is a walk, stretching or wellness education, nobody is left behind with a tailor made schedule to fit all work modifications. We want your employees to be BETTER, faster!

What could be better than finding out that even though you have an injury you can maintain and/or even improve your habits

The simplicity of having your employees on a modified work status program, coming into the Health and Wellness Room to learn about the injury that they suffer from, and discovering alternative ways to maintain weight and health while incapacitated, is reason enough to be excited that this option is out there for any sized company. I’ve been told by some employees in our Los Angeles Health and Wellness Room that they look forward to coming in after the weekend because they are getting better from stretching, walking, and maintaining a routine. Not only that, but the forestallment of future injuries is money saved as well. Because we are an advocate for the employer, we are your ally in employee recovery.