Claim Services for Employers
Beacon provides outstanding service programs, and our team of experienced claim representatives evaluates each case to determine and customize the best course of action. Our full range of claim services is covered by policyholder premiums and is also available to non-policyholders on a third-party administrator basis. Please review the services we provide and find out why Beacon Mutual is Rhode Island’s first choice in workers’ compensation insurance.
Stay-at-Work and Return-to-Work Programs
Studies repeatedly show the longer injured workers are out of work, the less likely it is that they will return to their job. The Beacon Mutual Insurance Company actively supports keeping workers in the workplace following an injury, in a suitable and safe position, while they recover. When that isn’t possible, we advocate for return to work as soon as medically indicated and within restrictions established by the physician. Case managers and ergonomists work with the injured employee, physician and employer to ensure a successful return to work. Additionally, guidance is provided to companies who wish to establish a stay-at-work/return-to-work program. Click here to learn more about the Stay-at-Work/Return-to-Work program.
Nurse Case Management
Beacon employs a staff of registered nurses to perform medical case management on selected workers' compensation cases. These employees are referred to as Nurse Case Managers (NCM). NCMs ensure appropriate medical care to assist the injured workers in achieving the highest level of medical improvement. NCMs are not claim representatives and approach claims as a patient advocate. NCMs pair with a claim team member to handle cases requiring extensive medical treatment. They give input to the claim representatives regarding medical matters, facilitate communication and education, and provide an overview of the medical status of a claim. NCMs expedite medical treatment and attend medical visits as warranted with the injured worker.
Telephonic Case Management
Telephonic case managers, who are Certified Case Managers and/or Certified Disability Management Specialists, provide in-house telephonic case management on claims. Early intervention is key in helping an injured worker understand his or her injury, coordinate prompt and effective treatment with appropriate specialists, and safely return to either a modified or full duty position.
The primary purpose of the ergonomic consultant is to assist in the return-to-work process by identifying the physical demands of a job as it relates to a particular worker's injury (diagnosis). Most often this entails analyzing the injured worker's regular duty job and one or more modified duty job options that can be offered to the employee. The ergonomic consultant provides his or her findings to the claim representative, medical providers and employer.
As part of the site visit and report, the ergonomic consultant may make administrative or engineering recommendations to the employer. Implementing these recommendations may increase the likelihood of securing a work release and/or increase the success of the injured worker's return to work.
Upon the injured worker's return to work, the ergonomic consultant can also provide one-on-one training and education in safe work habits. Ergonomic services are also available to workers who have not lost any time from work, but are receiving medical care for a work-related injury.
For more details on ergonomics and Beacon’s ergonomic services, visit our Ergonomics
While the goal of the Claim Department is to return injured employees to work at their current employer, in some circumstances that is not possible. The Beacon Mutual Insurance Company offers vocational services to injured workers when it has been determined that they are unable to return to their original employer in any capacity. Vocational services may include an initial vocational assessment, transferable skills analysis, testing, job seeking, skills training, resume/application preparation, interviewing skills and job placement assistance.
Utilization Management Group
Beacon’s in-house utilization management specialists, physical therapists, and nurse consultants ensure that treatments are based on evidence-based guidelines, are authorized appropriately and expeditiously, and are paid in an accurate and timely manner through Beacon’s medical bill review services.