The PINCH© Program is our proprietary, award-winning medical management program that provides a new perspective on how employers can best handle Workers’ Compensation claims.
The PINCH© Program is a proactive, three-step program, which is designed to address the needs of the employer, injured employee, and carrier.
- Step One: Our experienced staff work closely with the employer and all levels of management to design or refine your existing Workers’ Comp program. Forms, panels, and reporting procedures are reviewed and clarified for maximum efficiency. A transitional duty plan is addressed and instituted if needed. Managers and supervisors are educated as to the procedures, paperwork, and the importance of following a consistent plan.
- Step Two: At the time of each new injury, a nurse is available 24/7 for claim triage. We speak with the injured employee and gather information regarding the injury or illness, and provides recommendations to the employee regarding the appropriate level treatment. The initial medical treater is also contacted, if appropriate, and information is gathered. We then provide a brief initial triage analysis to the employer and carrier, which includes a summary, analysis of the injury, and recommendations to all parties to help manage the claim in the most effective manner. This allows for anticipation of medical treatment, reserve cost, and planning for transitional duty or out of work time.
- Step Three: A Case Manager, who provides aggressive management of both medical treatment and work status throughout the recovery process, follows each employee who is receiving ongoing treatment. We assist with specialist referrals, IMEs, and help to ensure that all treatment is received in a timely manner. Our case managers work with the injured employees both telephonically and onsite as needed.
The Result: Improved Employee Outcomes and Employer Cost Containment!
Remember: our goal with every employer is to focus on the big picture. First, is the employer prepared for each new claim? Do you know what to do, and do your employees know who to call when they are hurt? Next, our case managers work directly with each injured worker, from the time of injury forward, to make sure that their treatment is appropriate, timely, and cost-effective. Our goal is to obtain a return to work within one day of injury whenever possible! We work closely with the employer and insurance carrier to ensure that all parties have the updates and documentation needed, and that everyone clearly understands the employee’s treatment plan and progress. Finally, we move the claim toward closure by expediting treatment and recovery, and assist with IMEs, obtaining ratings, and other tasks that may be needed to close a file.
Your success is our success!
The HealthyWorkers(c) Program is designed to allow our nurses to work with employees and their health care providers to encourage identification and management of many chronic health conditions. Employers who enroll with our program enable their employees to achieve their best state of health, through education and improved compliance. We maintain contact with the employees to increase their understanding of chronic health conditions, and teach them the reasoning behind their prescriptions and the doctor’s treatment recommendations. Employees are comforted to know that their privacy is protected under HIPAA. And, by working closely with each employee, the result is both improved comprehension and compliance.
At least 45% of Americans have at least one chronic health condition, and treatment of these conditions accounts for 75% of healthcare costs.
Improved compliance with managing health conditions not only improves employee wellness and decreases healthcare costs, it decreases insurance payments, lower call-out days, and even improves workers’ compensation claims.
SHORT-TERM DISABILITY MANAGEMENT
When an employee is out on short-term disability, the employer often feels helpless and cut off from all information and is unable to anticipate a recovery timeline.
Our nurses can help!
Once an employee is approved for short-term disability, a case manager follows with the employee and treating physician on a monthly basis to provide support and education to the employee, as well as to determine a treatment plan and timeline for recovery. The employee is provided detailed education on their condition and recommendations for recovery. The employer is kept updated, within HIPAA guidelines, so that they are apprised of the employee’s progress.
This allows the employer to appropriately support the employee, as well as to plan for return to work.