Nurse Case Managers

11/1/2009
What are nurses doing at Beacon Mutual?

What are Nurses Doing at Beacon Mutual?


“What does a nurse do at an insurance company?”  This question often arises when an insured or injured worker learns that a nurse is calling from the Beacon. Here is an introduction to our role and how we can assist in making the medical management component of a claim less stressful and the sometimes confusing medical treatment process, less intimidating.

A group of seven Registered Nurses, of varying backgrounds, from Occupational Health to Orthopedic Nursing and Rehabilitation, are employed to advocate and assist in an injured worker’s medical care. We often work with individuals that have sustained multiple, complex injuries and need many different disciplines of medical provider; injured worker’s that may require surgery; and those cases that have pre-existing medical issues that may affect medical care. We can work to expedite treatment by finding an appropriate provider and coordinate both appointments and authorization for treatment. Here’s a typical example of the help one can receive from a nurse when someone has been injured and subsequently hospitalized after receiving emergency treatment.

Frequently treatment is sought at an emergency room or medical walk-in after an injury and occasionally a hospital admission may occur. Several days after the hospital stay, which may be anything from monitoring one’s medical condition to surgery, hospital nurse case mangers will look toward the insurance company’s nurses to help coordinate a discharge home. We will assist in everything from the transportation home, any home medical equipment or home care services (nursing, therapy, etc.) and making follow up doctor appointments. We are able to attend your medical visits as well, if requested, to answer both your and the provider’s questions, do authorizations at the time of request and to advocate on your behalf for proper, appropriate and timely treatment.

We do not provide direct care, but can oversee an appropriate rehabilitation plan and assist with any issues that arise over the course of medical treatment. We are well known by most of the providers of orthopedic, rehabilitation and trauma care and serve as a valuable resource to the road to recovery as part of your medical team. So when a nurse is calling from the Beacon be ready with your questions and let us help you both as a resource and an advocate.