For the Employer


How to Report an Injury

Employer Responsibilities

Employers can make a big difference by reporting injuries to The Health Plan Managed Workers' Compensation Program (MWCP) immediately. The earlier The Health Plan Managed Workers' Compensation Program (MWCP) is aware of an injury, the sooner we may begin investigating the injury and assist employees to the appropriate medical providers.

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The Health Plan Managed Workers' Compensation Program (MWCP) Identification Card

The Health Plan Managed Workers' Compensation Program (MWCP) identification cards should be distributed to all employees and used for work-related injuries only. When an injured worker seeks treatment for a work related injury, he or she should present their identification card to assist in identifying the employer and MCO. This will assist in expediting medical treatment and the claims process.

If you would like to order additional identification cards or have any questions or concerns, contact The Health Plan Managed Workers' Compensation Program (MWCP) via email or by calling 1.888.847.7810 ext. 6109. (Front and back of card shown below.)

Front of Card

Back of Card

Services

Case Management
Case Management is a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates options and services to meet a client's health needs through communication and available resources to promote quality, cost-effective outcomes.

The Health Plan Managed Workers' Compensation Program (MWCP) is certified in Case Management by the American Accreditation HealthCare Commission (URAC). We have certified Case Managers (CCM) who work with injured workers, employers, and healthcare providers to perform the functions of Case Management. The ultimate goal in working with injured workers is to assist them in reaching an optimal level of functioning and wellness while achieving a safe and timely return to work. In working toward this goal, it is the Nurse Case Manager's responsibility to ensure that services are appropriate to the injury and generated in a timely and cost-effective manner.

Vocational Rehabilitation
Vocational Rehabilitation is the process of restoring an individual’s ability to work. Our goal at The Health Plan Managed Workers' Compensation Program (MWCP) is to integrate Vocational Rehabilitation services with your return-to-work policies to save money and reduce lost-time days.

Vocational Rehabilitation is an individualized program for eligible injured workers needing assistance in safely returning to work or in retaining employment. Vocational Rehab emphasizes restoring or maximizing the injured worker's abilities and minimizing long debilitating absences from work.

Vocational Rehabilitation benefits employers by providing:

Qualified Health Plan (QHP)
The Health Plan Managed Workers' Compensation Program (MWCP) is certified by the Ohio Bureau of Workers' Compensation to provide managed care services to Ohio's injured workers. With this certification, The Health Plan Managed Workers' Compensation Program (MWCP) offers self-insured employers the ability to design and implement a Qualified Health Plan (QHP) for employees injured on-the-job.

Self-insured employers may select from a menu of services or select The Health Plan Managed Workers' Compensation Program (MWCP) to fully administer the plan. We are flexible in designing and implementing a plan that works best for you and your employees.

The Health Plan Managed Workers' Compensation Program (MWCP) offers the following managed care services:

Quality Assurance
The Health Plan Managed Workers' Compensation Program (MWCP)'s quality improvement program monitors and evaluates the effectiveness of Case Management and claims management. The Quality Assurance Committee maintains and updates policies and procedures, ensures compliance with URAC standards, and assesses the quality of treatment reimbursement decisions and billing procedures in connection with approved treatment decisions. The Health Plan Managed Workers' Compensation Program (MWCP)'s Quality Assurance Program is responsible to ensure quality Case Management of Ohio's injured workers by tracking key quality indicators.

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Grievance and Dispute Process

Grievance Process
The Health Plan Managed Workers' Compensation Program (MWCP) provides for a grievance process for operational, non-medical complaints including case management activities that may arise between the claim parties. Issues can be reported either telephonically or in writing to the Manager. All efforts will be made to resolve the issue within 48 hours of notice. Unresolved issues will be forwarded to the Director of Employer Services for review and action.

The Alternative Dispute Resolution (ADR) process is intended to handle medical disputes regarding quality assurance, utilization review, medical necessity and other treatment and provider issues. Disputes must be received in writing within 14 days of receipt of written notice of a treatment determination.

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