Patient transport helps build bridge back to workPosted On: Apr. 16, 2015 12:00 AM CST
Providing injured workers with nonemergency transportation services can improve outcomes and return-to-work times.
Genex Services L.L.C. is rolling out a research-based guide, which it said its case managers and clients requested, about when, where and how to transport injured workers, the Wayne, Pennsylvania-based provider of workers comp clinical services said Tuesday.
The guide includes information about which mode of transportation and which provider might be best for injured workers in emergency and nonemergency situations, Genex said in a statement.
In nonemergency situations, “a wide range of factors” determines whether workers comp payers reimburse injured workers for transportation to and from medical appointments and therapies, a Genex spokeswoman said.
For example, payers should consider whether an injured worker's condition requires medical attention during transport, or whether nonemergency transport via ambulance could avoid exacerbating an injury, according to the statement.
While Genex does not provide transportation services, companies that do say some workers comp payers already have their own guidelines.
Typically, payers reimburse workers for nonemergency transportation services because “they would rather have injured workers get to their appointments, and make sure they keep progressing from an overall care standpoint and a return-to-work standpoint,” said David Huth, Memphis, Tennessee-based vice president of product development at pharmacy benefit manager Helios.
Payers use the PBM's nonemergency transportation services when workers are restricted from driving due to injury or medications, among other reasons, Mr. Huth said.
Nonemergency transportation costs exceed $700 per mile in some metropolitan areas, according to Genex's review of 2014 data. However, sources agree that the cost is worth it for payers in certain situations.
“From a client perspective, if the alternative is for the injured worker to try and schedule a cab or get (to appointments) on their own, they'd rather have us coordinating it to make sure the appropriate level of care is provided,” Mr. Huth said. “We're managing the reminders, making sure they're attending (appointments) and compliant.”
Claimants need to get to doctor appointments, physical therapy or light-duty work, said Aaron Crowell, St. Louis-based vice president of claim services at MTM Inc., a medical transportation management company. Transportation becomes a return-to-work “barrier if (a worker is) counting on a family member or some other mode, like a volunteer service, that for some reason becomes unavailable.”
For traumatic injuries, such as a severe burn or the loss of a limb, payers should call 911 rather than a transportation service, sources said.