Talk often – and early
In order to take full advantage of any relationship, you need to talk on a regular basis. You need to talk with your attorney, of course, and with your accountant and with your banker. And you need to talk with your MCO representative, too.
Because the more you talk, as with so many other relationships and business deals, the more you or your representative might recognize an opportunity.
Say, for instance, that you own and operate a manufacturing plant. You might want to ask whether an MCO has experience working with other manufacturing businesses or, in contrast, does it specialize more with city, state and white-collar businesses? You might also want to ask about the MCO’s process to provide you with information and how often it provides that information, whether it’ll meet with you to discuss your claims and whether you’ll be able to talk with your case manager and your medical director. Ask how the MCO plans to work with your third-party administrator, how it assigns case managers and whether it can tailor its program to meet – and perhaps even exceed – your needs. Any of those questions and subsequent answers could lead to greater efficiency, a better return-to-work rate or even lower premiums in the future.
"Ask them the simple questions about how they work, because not all MCOs fit every employer," Conger says. "Some MCOs may do things differently or their processes may not fit."
Because of the lack of time available for MCOs to reach out and provide their pitch and information, it’s important that you prepare yourself for May 3 as early as possible and have an idea of which MCOs interest you. And if you narrow the field early enough to two or three or four, you can even pick up the phone and call them.
"Employers are allowed at any time to contact an MCO, even if it’s not their own MCO, to request information, to request a face-to-face meeting, and they can do that even outside of an open enrollment period," Poach says. "Employers do have an opportunity to reach out now. The sooner they start that, probably the more MCOs they’ll be able to interview and seek information from, and the more informed they’ll be in making their MCO selection."
