What is Nurse Case management, and why is it important to your workers’ comp cost containment?

Updated: Feb 19, 2019

Our Nurse case managers meet patients at the patients' home, in the Dr's office and in the hospital.

PDI’s Nurse Case Managers are committed to altering the injured workers life for the better. PDI’s case management philosophy focuses on the management and coordination of care through efficient use of resources. Cost containment, while essential, is not the only goal.

Quality and continuity of care, coupled with the assurance of appropriate and timely intervention, are crucial elements for recovery and promoting a stay at work/return to work philosophy. By approaching the case with these goals, our nurses facilitate treatment options and services focused on the identified health needs. This approach decreases the fragmentation and duplication of treatment, while ensuring the right treatment, at the right time, with the right provider.

PDI’s philosophy centers around the concept that the best opportunity to medically impact a claim and reduce days away from work is at the most critical stage, the beginning. PDI's Nurse Advice & Injury Reporting line allows employees, including those in a dispersed workforce, immediate access to a Registered Nurse to discuss the nature of their injury. This not only provides the employee an instant advocate and clinical advice to treat their injury it also provides the employer with:

  • Decreased lag time in injury reporting

  • One point of contact at the time of injury creates a streamlined process for both the employee and the employer

  • Reduces OSHA recordable and reportable claims by providing self-care advice when applicable

  • Increased penetration of in-network options

  • Reduction in lost time/days away from work

  • Provides employees with an advocate to address their physical or emotional concerns, promoting improved workplace moral

  • Recording (mp3) of the initial report

PDI’s Nurse Case Managers work as intermediaries between carriers, attorneys, medical care providers, employers and employees to ensure appropriate and cost-effective health care services. A recent PDI White-paper reviewed outcomes from a large California public entity client, the results are as follows:

  • After the first year of the program, the entity saw a 56% reduction in days away from work, including a 61% reduction in days away from work for the Department of Public works.