Finding Value in After-Hours Calls for Your Practice

By Charlene McFeeley FNP-C, CME, CAOHC, LNC, NLCP, Excela Health WORKS

Optimizing After-Hours Occupational Medicine Services

In occupational medicine, we face a variety of dynamic challenges on a daily basis. Our average day is anything but routine. When handling Workers’ Compensation cases, employers rely upon their Occupational Medicine providers to limit OSHA recordable claims, manage the injury and costs, and promote the timely resolution of the claim.

Many employers prefer to have the Occupational Medicine providers manage their injuries after hours. Sending injured employees to an emergency department after hours has a higher likelihood of the use of durable medical equipment, sedating prescription medications, and incurring lost or restricted time, leading to recordability.

Traditionally, taking after-hours calls may not be attractive or profitable for the provider or clinic. How can after-hours calls fill a gap in care, add value, and decrease costs for your companies?

Creating an Effective After-Hours Service for the Company, Employee, and Clinic

Generally, a company hires a nurse triage service that uses established protocols to direct the care of the injured employee via a phone hotline to the correct level of care based on the acuity level. Many times, the call service works well for the employer and the injured worker. However, care can still become disconnected.

At Excela Health Works, we were aware of nurse triage hotlines that handle injuries after hours. However, we wanted to create a robust, customized service that not only met our companies’ needs but promoted continuity of care for the injured employee and generated revenue for our clinic, which may be lost in a traditional nurse triage service model.

After vetting other nurse triage programs, we chose TriageNow, located in Arizona, to provide our after-hours nurse call for several reasons. TriageNow offered:

1. Clinic branding of the service.
2. Experienced triage nurses.
3. Established triage protocols and first report of injury communication.
4. Self-care guidelines.
5. A reputation for caring for some of the largest companies in the U.S.

They were the right fit for our after-hours services. Excela Health Works, coupled with TriageNow services, has reinvented after-hours calls to achieve our clinic vision, extend service offerings and revenue opportunities, and fill a gap in care for our employers. Our model leveraged the clinical and business aspects of healthcare needed to stay viable in a specialty with a lower profit margin.

Clinic Branding

TriageNow allows private clinic branding. Simply, we branded our service as Excela Health Works After Hours. The name had a certain appeal, was quickly adopted, and was self-explanatory to employers and employees.

How to Implement After-Hours Service

The ease of implementation of services is key for the employer, employee, and clinic. The set-up of the after-hours service is done in advance and is a one-time process. Once launched, there is almost zero management on the clinical side of the process.

The Company Benefit and Value

The success of the after-hours service is in the implementation. Excela Health Works met with our companies, listened to their concerns about injury management after hours, and guided them through a standardized implementation process. Next, we:

1. Explained TriageNow, our service, branding for transparency, and access to a designated hotline that is tied to their own company.
2. Discussed their needs and collaboratively outlined expectations, protocols, and internal education and visibility about the service that ensured employee access to care.
3. Communicated the importance of the first report of injury. As we know, the details of claims may vary from the first report to the first clinic visit, thus influencing the course of care.
4. Developed a predetermined list of recipients for communication for the first report of injury. We added our clinic to the email communication, enhancing injury awareness for all, and improving the continuity of care.
5. Developed a customized manner of communication with the employer that ensured the injured worker had treatment at our clinic in the morning on the next business day, thus improving continuity of care, and promoting timely claim closure.
6. Discussed their set-up costs for implementation and pay by the injured worker approach. Our companies quickly embraced the service without concerns, and saw the value created by improved access to immediate care, decreased time away from work or lost time, cost control, and use as an employee benefit. Most important to the company was the continuity of care aspect that focused on timely follow-up and care with claim closure.

The Employee Benefit and Value

Excela Health Works After Hours is offered as an employee benefit by companies. Our service, coupled with the TriageNow hotline, ensures the injured employee receives:

1. Triage by experienced nurses (up to four calls per incident for continuity and access).
2. Immediate care guidance from the workplace.
3. Photo transmission ability.
4. Self-care with instructions or
5. Prompt referral to an emergency department or urgent care based on need.

The Clinic Benefit and Value

From a business perspective, Excela Health After Hours has realized the following clinic benefits:

1. Provision of service without additional staffing expense.
2. Revenue is associated with service on several levels while still reducing the costs for our companies.
3. Redirection of employees back to our front door.
4. Enhanced value to our relationship with the existing client base.
5. Door opener to gain new business.
6. Leverage in a competitive niche market.