Service Spotlight

Workers’ Comp Patient Transportation

In this Q&A, the VP of one workers’ comp service provider shares how to soothe a common pain point for injured workers: Getting to appointments on time.
By: | February 5, 2018 • 6 min read

Traditional transportation services meant to deliver injured workers to and from medical appointments may be at best inefficient, and at worst, antiquated. Both injured workers and payers want more control and transparency while also saving time and money.

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Historically, third party providers are limited in flexibility. In this Q&A, Linda Colsen, vice president and national product leader at One Call, shares how the industry can soothe transportation pain points.

R&I: What’s wrong with traditional transportation in workers’ comp?

First and foremost is time, particularly when there has been an issue with a missed appointment. Odds are, you don’t learn about a missed appointment until well after it has been missed. The process to reschedule an appointment in itself can be a headache. When adding in the time factor, an injured worker could be looking at days or in some cases, weeks later than the original appointment.

The second factor is the cost. In the perfect scenario, you need two drivers: one to take the injured worker to their appointment and the second to take them home. Until recently, however, there

Linda Colsen, vice president and national product leader, One Call

hasn’t been an effective solution to send a second driver to retrieve the injured worker from their appointment and transport them back to work or home. With traditional third-party transportation providers, payers end up spending a lot of dollars on wait time, which means paying a driver to sit in the parking lot while the injured worker is at their appointment.

Lastly is visibility, and specifically, a lack of visibility —knowing if the injured worker got picked up on time, if they overslept, if they’re on their way to the appointment and if they arrived on time.

R&I: How do these transportation challenges impact outcomes?

Without real-time visibility, delayed transportation may mean missed appointments, which means the injured worker doesn’t get the care they need. Rescheduling the appointment and another ride creates more logistical challenges for claims staff, case managers, injured workers and healthcare providers. Ultimately, missed appointments mean slower recovery and more stress for injured workers and higher costs for workers’ compensation payers. Transportation troubles leads to costly and subpar outcomes for everyone involved.

R&I: What can the industry do about it?

Technology has given us real-time, on-demand ride hailing services. For the average consumer, they offer more convenience and comfort for significantly less than a traditional cab. A real-time ride request reduces downtime because it can use drivers who are nearby. It also allows users to track their driver and cancel or reschedule a ride easily as well as log their ride history. We asked ourselves, ‘Why can’t we use this in workers’ comp?’

One Call decided to leverage this technology with the creation of RelayRIDE, which may be used for any injured worker needing transportation to medical appointments. Real-time visibility enabled by the RelayRIDE technology means the One Call team can monitor ‘live’ trips in progress and take steps to mitigate issues, such as driver cancellations, by quickly scheduling the trip with another driver. This active trip monitoring means injured workers receive the treatment they need quickly, which may result in a shorter claim life.

R&I: How does it work?

We partnered with Lyft in August 2016, originally utilizing their services to handle the more difficult, rush cases.

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Over the course of the partnership, we have developed our proprietary web-based application, which connects directly to Lyft through an open application programming interface (API). This allows One Call to seamlessly utilize RelayRIDE to fulfill ambulatory transportation referrals if the request is in a Lyft coverage area.

Once a ride has been scheduled, One Call initiates a series of text messages to inform the injured worker of their transportation arrangements. They provide details about their upcoming ride such as driver identification, vehicle information and ride tracking. These text messages also enable injured workers to request a return ride with the press of a button on their phone. Wait time charges are eliminated for rides fulfilled through RelayRIDE as each leg of the trip is handled independently. At the end of their ride, they are able to provide instant feedback by rating their ride experience and driver.

One Call has a team dedicated to monitor rides in real-time through RelayRIDE. Through this active monitoring, our team is alerted to potential issues and can be proactive in addressing transportation issues that historically resulted in missed appointments. We will immediately notify the medical provider if an injured worker is a “no show” or if a late arrival is anticipated, which ultimately reduces the administrative burden on our customers’ to make multiple follow-up calls.

One Call decided to leverage this technology with the creation of RelayRIDE, which may be used for any injured worker needing transportation to medical appointments. Real-time visibility enabled by the RelayRIDE technology means the One Call team can monitor ‘live’ trips in progress and take steps to mitigate issues, such as driver cancellations, by quickly scheduling the trip with another driver. This active trip monitoring means injured workers receive the treatment they need quickly, which may result in a shorter claim life.

R&I: Have you seen any benefits from this program yet?

Lyft drivers have provided more than 100,000 “rush” rides this year. These are rides for non-emergent ambulatory appointments.

For us, visibility and transparency are the biggest benefits. Claims managers and nurses can see active rides and ride history through the web portal. They know right away if a driver didn’t show or is delayed. They can act immediately to either arrange a new ride or to reschedule the appointment. They’ll know if a patient missed an appointment and can reach out to them sooner rather than later. It removes some decision-making steps for the patient and cuts out some of the cost and liability of using a traditional transportation service.

R&I: What are other key benefits of using a modern ride-sharing service?

By helping patients keep their scheduled appointments, it can prevent expensive emergency room visits. The system can also track appointment history and mileage for reimbursement purposes. The transparency and accountability components may also reduce likelihood of fraud.

R&I: What about from the patient’s perspective?

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Approximately 98 percent of American adults have internet access. This program is reaching patients where they are at that moment and creating a seamless experience for them; they can request, track, or cancel a ride and see their history through the online dashboard. If they don’t want to log on and schedule a ride themselves, they can text “N” to our dispatchers who will send a driver for them.

The program will also send text reminders to patients 20 minutes before their driver is set to arrive, so they can be ready to go.

R&I: Are there other ways that technology can address challenges in worker’ comp?

Live video conferencing is increasingly playing a role in workers’ comp. Most of the conversation is centered on telemedicine —connecting doctors and patients when in-office visits aren’t feasible. But we’re applying video consultation to a different challenge: language barriers. Patients with Limited English Proficiency (LEP) may struggle to communicate with their medical provider, and if they can’t understand their treatment plan they are far less likely to stay engaged in their recovery.

RelayTRANSLATE is our technology-enabled video interpretation solution that is part of a broader program we’re developing called RelaySOLUTIONS, which also includes RelayRIDE. Through RelayTRANSLATE, the injured worker can request on-demand interpretation in their chosen native language, and the platform will connect them with a live person who can interpret for them via video. This is absolutely critical to achieve better outcomes for patients. &

Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

R&I Profile

Achieving Balance

XL Catlin’s Denise Balan stays calm and focused when faced with crisis.
By: | January 10, 2018 • 6 min read

In the high-stress scenario of kidnap or ransom, the first image that comes to mind isn’t necessarily a yoga mat — at least, not for most.

But Denise Balan, senior VP and head of U.S. kidnap & ransom, XL Catlin, who practices yoga every day, would swear by it.

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“I looked at these opposing aspects of my life,” she said. “Yoga is about focus, balance, clarity of intent. In a moment of stress, how do you respond? The more clarity and calmness you maintain, the better positioned you are to provide assistance in moments of crisis.

“Nobody wants to be speaking to a frenetic person when either dealing with a dangerous situation or planning for prevention of a situation,” she added.

“There’s a poem by [Rudyard] Kipling on that,” added Balan’s colleague Ben Tucker. “What it boils down to is: If you can remain calm, you can manage through a crisis a lot better.”

Tucker, who works side by side with Balan as head of U.S. terrorism and political violence, XL Catlin, has seen how yoga influences his colleague.

“The way Denise interacts with stakeholders in this process — she is very professional and calm in the approach she takes.”

Yin and Yang

Sometimes seemingly opposite or contrary forces may actually be complementary and interconnected. In Balan’s life, yoga and K&R have become her yin and yang.

She entered the insurance world after earning a juris doctor degree and practicing law for a few years. The switch came, she said, when Balan realized she wasn’t enjoying her time as a commercial litigator.

Denise Balan, senior VP and head of U.S. kidnap & ransom, XL Catlin

In her new role, she was able to use her legal background to manage litigation at AIG, where her transition from law to insurance took place. She started her insurance career in the environmental sector.

In a chance meeting in 2007, Balan met with crisis management underwriters who told her about kidnap and ransom products.

She was hooked.

Because of her background in yoga, Balan liked the crisis management side of the job. Being able to bring the calmness and clearness of intent she practiced during yoga into assisting clients in planning for crisis management piqued her interest.

She then joined XL Catlin in July 2013, where she built the K&R team.

As she became more immersed in her field, Balan began to notice something: The principles she learned in yoga were the same principles ex-military and ex-law enforcement practiced when called to a K&R-related crisis.

She said, “They have a warrior mentality — focus, purpose, strength and logic — and I would say yoga is quite similar in discipline.”

“K&R responders have a warrior mentality — focus, purpose, strength and logic — and I would say yoga is quite similar in discipline.” — Denise Balan, senior VP and head of U.S. kidnap & ransom, XL Catlin

Many understand yoga to be, in itself, one type of meditation, but yoga actually encompasses a group of physical, mental and spiritual practices. Each is a discipline. Some forms of yoga focus on movement and breathing, others focus on posture and technique. Some yoga is meant to relax the mind and create a sense of calmness; other yoga types make participants sweat.

After having her second child and working full-time, Balan wanted to find something physical and relaxing for herself; a friend suggested yoga. During her first lesson, Balan said she was enamored with it.

“I felt like I’d done it all my life.”

She dove into the philosophy of yoga, adopting the practice into her daily routine. Every morning, whether Balan is in her Long Island home or on a business trip, she pulls out her yoga mat to practice.

“I always travel with my mat,” she said. “Daily practice is the simplest form of connection to routine to maintain my balance — physically and mentally.”

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She said the strangest place she has ever practiced was in Lisbon. She was on a very narrow balcony with a bird feeder swarming with sparrows overhead.

After years of studying and practicing, Balan is considered a yogi — someone who is highly proficient in yoga. She attends annual retreats with her yoga group, where she is able to rejuvenate, ready to tackle any K&R event when she returns.

In 2016, Balan visited Tuscany, Italy, where she learned the practice of yoga nidra, a very deep form of meditation. It’s described as the “going-to-sleep stage” — a type of yoga that brings participants to a state of consciousness between waking and sleeping.

“It awakens a different part of your brain,” Balan commented. “Orally describing it doesn’t quite do it justice. One has to practice Nidra to fully understand the effect it has on your being.”

Keeping a level head during a crisis is key in their line of business, Tucker said. He can attest to the benefit of having a yogi on board.

“I’ve seen her run table-top exercises where there is this group of people in a room and they run an exercise, a simulation of a kidnap incident. Denise is very committed to what we’re doing,” said Tucker.

“She brings that energy. She doesn’t get flustered by much.”

Building a K&R Program

When Balan joined XL Catlin, she was tasked with creating the K&R team.

Balan during a retreat in Sicily, Italy, 2017

She spent time researching and analyzing what clients would want in their K&R coverage. What stuck out most to Balan was the fact that, in these situations, the decision to purchase kidnap and ransom cover is rarely made because of desire for reimbursement of money.

“I asked why people buy this type of coverage. The answer was for the security responders,” she said.

“These are the people who sit with the family. They’re similar to psychologists or priests,” Balan further explained. “Corporations can afford to pay ransom. They buy [K&R] because it gives them access to these trained and dedicated professionals who not only provide negotiation advice, but actually sit with a victim’s family, engaging deep levels of emotional investment.”

“I’ve learned to appreciate all moments in life — one at a time. The ability to think clearly and calmly guides my work, my practice and my personal life.” — Denise Balan, senior VP and head of U.S. kidnap & ransom, XL Catlin

Balan described these responders as people having total clarity of purpose, setting their intentions to resolve a crisis — a practice at the very heart of yoga. She knew XL Catlin’s new kidnap program would put stock in their responders.

“I’ve worked closely with the responders to better understand what they can do for our clientele. These are the people who run into danger — warrior hearts married to dedication to our clients’ best interests.”

But K&R is more than fast-paced crisis and quick thinking; Balan also spent a good deal of time writing the K&R form and getting the company’s resources in order. This was a huge task to tackle when creating the program from the ground up.

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“A lot of my day-to-day is speaking with brokers and finding ways to enhance our product,” she said.

After a few months, she was able to hire the company’s first K&R underwriter. From there, the program has grown. It’s left her feeling professionally rewarded.

“People don’t often get that opportunity to build something up from scratch,” she said. “It’s been an amazing experience — rewarding and fun.”

“She brings groups of people together,” said Tucker. “She’s created a positive environment.”

Balan’s yogi nature extends beyond the office walls, too. Her pride and joy, she said, are her kids. And while it may seem like two large parts of her life are opposite in nature, Balan’s achieved balance through her passions.

“[Yoga] has given me the ability to see beyond only one aspect of any situation” she said. “I’ve learned to appreciate all moments in life — one at a time. The ability to think clearly and calmly guides my work, my practice and my personal life.” &

Autumn Heisler is a staff writer at Risk & Insurance. She can be reached at [email protected]