The Nurse Hotline: The First Step in a Work Injury Claim

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Did you know that over 2.9 million workplace injuries occur each year? Accidents and injuries happen, but the common goal is to limit the number of injuries and keep employees as safe as possible. When an injury does happen, there is a process that is followed, and filing a Workers’ Compensation claim is typically an early part of that process.

There are companies that have unique medical management programs to deliver services to insurance carriers. Central Insurance, for example, partners with a company to offer its policyholders a useful service called the Nurse Hotline.

The Nurse Hotline is a modern solution to the first report of a work-related injury, providing telephonic nurse triage for all workplace injuries. This allows for claims to be opened within minutes of their occurrence and injured workers to be immediately directed to the appropriate medical facility for their treatment. Additional benefits of this program include:

  • 24/7 access to medical advice from Registered Nurses (RNs) for workplace accidents.
  • Reduced time that employees are out of work.
  • Reduced claim costs with urgent care facilities being utilized in lieu of emergency rooms.
  • More appropriate treatment due to home care recommendations.

Here are some FAQs about the Nurse Hotline Program:

So how does this program work?

When a workplace injury occurs, the injured worker and their supervisor call the designated nurse hotline number to report the claim and they are immediately connected to an RN. The RN will direct the injured worker to the appropriate medical facility should additional medical treatment be needed.  Additionally, the RN will provide the medical facility with the injured worker’s paperwork as they anticipate the patient’s arrival. As always, should this be a life-threatening injury, 911 should be contacted directly.

Who should talk to the nurse?

If at all possible, the nurse will need to speak directly with the employee who has sustained an injury. As part of the medical triage process, the nurse will be asking personal, medically-directed questions including past medical history, any current medical problems and medications, allergies, and the patient’s perception of their own symptoms.

What if the employee has sustained a serious injury?

This service is designed to assist with injuries that are not life, limb, or eyesight threatening. If the employee has a serious injury that requires Emergency Medical Services, then 911 or local EMS number should be called.

What do the RNs do?

The RNs assist injured employees in determining a recommended course of action for appropriate care and ensure the earliest intervention possible for return-to-work initiatives. This professional nurse hotline service provides answers asked by injured employees, guiding them on appropriate levels of care for their medical issues.

What type of nurses will be answering the phone?

The Nurse Hotline is staffed by experienced, registered nurses. The nurses have additional training to answer calls specifically related to injuries incurred in the workplace.

Will they have enough nurses to answer all our calls?

Yes, of course! The call center strives for an average speed of answer of 30 seconds or less. If there is a hold time it will be a very rare occurrence.

What languages are available through the Nurse Hotline?

Spanish is available 24 hours a day. If the Spanish speaking RNs are on other calls, the language line will be used. In addition, the language line is available for any other language, at any time.

How long will the call take?

The average call time is approximately 18 minutes, but each call is unique to the situation. While the nurses are trained in the management of the call process, their priority is to provide all information necessary to the employee to fully understand the recommended course of action and/or the instructions on self-care.

What if the injured worker is a minor?  

The nurse will ask if a parent or guardian is available to be included in the call. If the parent or guardian is not available, the nurse will continue the triage process.  

Can the employee call the nurse back if they have additional questions or symptoms?

Yes. This is encouraged. Many times, a patient will have a question after they followed the nurse’s recommen­dation and/or before the first visit with an approved panel physician. During the triage process, the nurse will ask permission from the employee to call back, as necessary, and gather appropriate contact information. For all urgent, emergent, and self-care calls where a change in condition is expected, the nurse will attempt to complete a callback.

Will the nurse complete a Report of Injury?

Yes, the nurse will obtain the necessary information to complete an Injury Report. Following the call, this injury report will be sent to the dedicated distribution log.

Should the supervisor call the Nurse Hotline and report the injury, if the injured employee does not want to call?

Yes. Again, calling the Nurse Hotline is the method used by the employer to report work-related injuries to the Workers’ Com­pensation administrator. While it is not necessary to talk to a nurse, a claim can still be reported to a First Report of Injury Customer Services Representative. The supervisor should provide information that is available.

Contacting the Nurse Hotline is the preferred method for an employer and an injured worker to report a workplace injury. This service is available 24 hours a day, 7 days a week, and 365 days per year and will save valuable time and money to the injured worker and the insured. Contact your independent agent to see if your Workers’ Compensation policy includes a Nurse Hotline service!

The information above is of a general nature and your policy and coverages provided may differ from the examples provided. Please read your policy in its entirety to determine your actual coverage available.

Copyright © 2020 Central Mutual Insurance Company. All rights reserved.

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