What Happens After You Report a Claim?

Three Calls in the First 24 Hours

Why the first 24 hours matter

The next day or two after someone is hurt at work sets the tone for the entire claim. The injured worker wants to know if they will be paid and how to get care. Managers need clear steps, not guesswork. If no one communicates quickly, people assume the worst, and simple claims become complicated.

PCM’s three-point contact model is designed to avoid that gap. As soon as a claim is entered into their system, a team reaches out to three people: the injured worker, the treating provider, and the employer.

What is PCM’s three-point contact?

When PCM receives a new workers’ compensation claim, they follow a defined sequence in the first 24 hours:

1. Contact the injured worker
2. Contact the doctor or clinic
3. Contact the employer or designated contact

After those three contacts, the file moves to the dedicated adjuster, who continues communication throughout the life of the claim.

The goal is simple:

• Make sure the injured worker knows who is handling their claim
• Make sure the provider knows how to treat and bill correctly
• Make sure the employer is heard and informed from the start

First contact: the injured worker

For non-emergency injuries, Medcor’s nurse triage team provides immediate clinical guidance. They speak with the supervisor and the injured worker, provide first-aid or self-care instructions, and decide whether the employee should be seen in a clinic or an ER or can safely return to work.

Once the incident is reported electronically to PCM through Occlink, PCM’s first three-point contact is with the injured worker.

In that call, PCM:

• Confirms that the claim has been received
• Explains how wage replacement and medical benefits work in basic terms
• Provides instructions on what to expect next in the claims process and how communication will work going forward

The effect is immediate. The worker knows which team is handling their claim, how they will keep paying their bills, and who to call with questions.

When injured workers get clear, early information, they are less likely to feel abandoned. That lowers the chance they bring in an attorney just to get someone to talk to them, which is one of the biggest drivers of long, expensive claims.

Second contact: the doctor or clinic

The second call goes to the treating provider.

PCM uses this contact to:

• Confirm how to obtain treatment authorization
• Provide billing details and the address to which invoices should be sent
• Identify the adjuster and the best contact information

This keeps the focus on appropriate care instead of administrative friction. The provider knows who is responsible for the claim and how to get answers.

For members, this reduces delays, miscoded bills, and duplicate visits. It also helps avoid unnecessary treatment that can drive up costs without improving outcomes.

Third contact: the employer

The third contact is with the member.

PCM reaches out to the employer’s point person to:

• Confirm what happened from the employer’s perspective
• Capture any concerns or context about the incident
• Clarify any missing information from the initial report

This is where operational reality meets the claim file. Managers and owners know the employee, the location, and the circumstances in a way no form can capture. Getting that information into the claim early allows PCM to act quickly if something looks unusual and to align on return-to-work expectations.

Members who do this well usually have a clear internal contact for claims reporting. That person knows how to use PCM’s Occlink portal and is ready to take these calls.

Why this model matters for CRMBC members

In a self-insured group, there is a direct connection between how claims are handled and the group’s bottom line. Every unnecessary dollar paid on a claim comes from the pool members have funded.

Three-point contact supports members on two fronts.

• • Care and experience for the injured worker
    Early outreach, clear information, and a single point of contact reduce confusion and stress. Workers feel taken care of, which supports recovery and return to work.

• Financial implications
  When people do not hear from anyone, they turn to attorneys. Litigated claims last longer, cost more, and consume time and attention. By contacting the worker, doctor, and employer in the first 24 hours, PCM reduces the number of claims that head down that path.

This is also a key way CRMBC differentiates itself from traditional fully insured programs and from prior TPA experiences, where some workers waited weeks before hearing from anyone about their claim.

How members can support three-point contact

PCM’s process works best when members do a few simple things consistently:

• For non-emergency injuries, call Medcor nurse triage at 1-872-260-6022 first so the worker gets immediate clinical guidance. Then report the incident electronically to PCM, even if Medcor recommends self-care.
• Provide complete contact information for the injured worker and for your internal contact person.
• Tell the worker to expect a call from PCM and encourage them to pick up or call back.
• Share concerns early. If anything about the incident or the claim seems off, raise it in that first conversation.
• Document and share written return-to-work offers when the worker is medically cleared. This has a direct impact on claim costs and long-term exposure.

Ready to strengthen your first 24 hours?

If you’re a CRMBC member, now is a good time to review how incidents move from your locations into PCM’s hands:

• Confirm you have a clear internal point person for claims
• Make sure your managers know how and when to use the PCM/Occlink portal
• Align your reporting and return-to-work steps with the three-point contact model