medcor injury triage

Click to view a 90 second overview of the Medcor Injury Triage Service

More than 20 years performing work comp premium audits has allowed us to observe clients' efforts to implement countless cost containment solutions and their effectiveness; what works and what doesn't.  And, ever since Medcor invented workplace Injury Triage, this one service has proven its value in enough organizations and industries that it’s considered by many as an industry best practice.  

Benefits that Medcor Injury Triage customers enjoy include:

  • Reduced Claims

  • Reduced Costs

  • Reduced Litigation  

  • Reduced Experience Modification Factors

  • Improve Return To Work Program Performance

Historically, 43% of calls to Medcor do not result in claims.

What Is Injury Triage

A common mistake made by employers is allowing the supervisor to decide what to do following a workplace injury.  

Injury Triage is a preclaim service putting the responsibility of this decision into the hands of a medical professional.  This help employers make good decisions about what to do when one of their employees gets hurt.  

If a call results in self care or a referral (to your clinic or the ER) , the claim is on the right track from the beginning.  It's on course for an optimal outcome for both employee and employer.

Employees and supervisors, in most cases, don't have medical training.  

 

Injury Triage is a system to identify serious cases that need medical diagnosis and treatment, get people the right level of care, in the right time frame, using in-network providers.  Additionally, Injury Triage is also a way to identify the minor cases that can safely be resolved with first aid; those incidents that do not need to become claims.

In other words injury triage is for anything more severe than a bandaid and less than an ambulance; a preclaim activity that supports the decision making process determining whether or not an incident will become a claim or not.

Medcor Aggregator

If you have 80 or more claims per year, I'm going to stop you right here and suggest you speak with Medcor directly.  They have an 80 call minimum.  So, you will pay for 80 calls per year regardless.

We can still consult with you to help you leverage Medcor to support even broader goals; such as improving your Return To Work Ratio.  But, with respect to paying for the Medcor service, your per call charge will be lower if you are above that 80 claim per year threshold.

Cytron Group LLC is a Medcor Aggregator.  By accessing the Medcor network through our aggregator relationship you can receive the same service and reap the same savings as larger organizations albeit with smaller claim volume than a typical Medcor client.  

There is no minimum call commitment by accessing the Medcor network through our aggregator relationship.  Just a small annual fee for the service in addition to the standard per call fee.  You can still add this necessary component of a best in class work comp system, and you won't pay for more than you need.

There Is No Risk Giving Medcor A Chance To Save You Money​

There are no contracts committing you to a length of time or forcing you to call when you have accidents in the workplace.  You pay a small fee per call.  If you believe you are not gaining a sufficient benefit/ROI from Medcor, you can just quit calling (but you won't!).

Medcor Customers Include

Large, well know employers with best-in-class workers' compensation programs utilize Medcor including Wal-Mart, Target, Dollar General and McDonalds.

Case Studies

 

The following data was provided to us by Zurich; the client's work comp carrier.  What is significant about this is that the client is on a guaranteed cost program.  So, the carrier is benefiting directly from the decreased claim cost, but the employer will benefit from a reduced Experience Modification Rate.

 

·       Customer had 63 total calls/incidents in 2018.

·       31 (49%) of the calls resulted in self-treatment/first aid rather than off-site medical treatment.

·       Those 31 calls represent incidents that would have otherwise resulted in 31 claims appearing on customer’s experience mod worksheet for 3 years.

·       Customer’s average med-only claim cost was $685 in 2018. So, $21,235 (685 X 31) in claims won’t appear on customer’s experience mod worksheet for 3 years.

Additionally, both the carrier and employer benefited from claims that remained medical only rather than lost time thanks to Medcor.

We can provide you with more case studies and data if you'd like to call, request this information, and let us know your objectives (e.g. reducing your EMR, reducing costs of your deductible program, trying to position yourself to enter a captive, etc) in order to provide you with the most relevant data.

 

Insurance Carrier Paid or Subsidized?

Sometimes it's possible to have your work comp carrier either pay for Medcor or subsidize some or all of it for you.  Please contact us for more information.

The ROI of Injury Triage

Loss Sensitive Program:  High Deductible, Self-Insured, Group Captive, Retro

If you’re on a high-deductible program with, say, a $250,000 per incident deductible, every dollar of each claim up to $250,000 comes out of your pocket.  Self-insureds, of course, pay everything.  All of the savings from your Injury Triage service result in money that remains in your bank account.  The savings, and resulting ROI, on these programs are significant, direct and easy to measure.

Guaranteed Cost Program:  Experience Modification Rate

Even if your on a Guaranteed Cost/First Dollar work comp program, the reduction in the number of claims (frequency), claim expenses (severity), and the duration of claims (severity) will have a substantial ROI.  Upon implementation of the Medcor service, you are 2 renewals away from seeing the results impact your experience modification factor.  If your renewal is 1/1, then the current year's policy will roll into your experience modification rate in 2 renewals.  So, if we're in 2019 now, this year's policy (1/1/19 - 20) will first appear in your 1/1/21 experience modification rate.

 

Then, keep in mind that the improvements to your experience modification rate from your Injury Triage Program will continue to compound until all 3 years' experience in your "mod" will reflect Medcor years.  In the example above you will add a 2nd policy year under your Medcor program on 1/1/22 and, subsequently, a 3rd on 1/1/23.

 

Guaranteed Cost Program:  Other Savings

Our decades of experience as premium auditors has demonstrated to us all of the other savings opportunities that arise as the claims cost (associated with your company) to your work comp carrier improves.

Lower Rates:

Improvements in your claims experience and consistently lower costs makes your underwriter not only more comfortable writing your business, but also increasingly interested in keeping it.  As your costs are decreasing, you are also becoming a more profitable account.

 

Although technically an insurance company can not offer rates other than what they file with the state, they get around these restrictions by having numerous "underwriting companies;" different legal entities owned by the same parent with different filed rates.  Your current carrier, anticipating fewer losses, may move your business into one of their underwriting companies with lower filed rates.  

 

Also, insurance companies who had not previously been interested in your business due to loss history may now want to quote.  Increasing competition puts downward pressure on rates.

Schedule Rating:

Similarly, if you look at your work comp policy or a final audit statement, you’ll see a line item called “Schedule Modification” or “Schedule Rating.”  This is either a debit or credit and typically moves up or down in correlation with your experience mod.   Businesses with good experience mods, few claims, etc. typically have Schedule Credits (reduced premium).  Businesses with high mod, numerous claims, severity issues, etc. typically have Schedule Debits (additional premium).  Injury Triage benefits could compound as your underwriter rewards your improved claim performance through the carrier’s Schedule Rating Program; reducing premiums and boosting ROI.

Stuart Cytron

stuart@cytrongroup.com

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