In May, Ohio businesses will, for the first time since 1998, have the option of switching the managed care organization that handles their workers’ compensation claims.
The Ohio Bureau of Workers’ Compensation grants businesses this opportunity once every two years through open enrollment, which begins May 1 and closes May 31.
Businesses should take advantage of this time, either to select new managed care organizations, if they have been dissatisfied with their current ones, or to assess their overall workers’ compensation program.
While you may generally be pleased with your MCO, it still could be beneficial for your employees to ask these questions of your plan: Are you getting the service you expected? Are your premium costs under control? How are your return-to-work rates? Is the communication as good as it could be?
A general assessment could make comparison-shopping worthwhile.
If you decide to look around, consider these tips:
Start early. You have about two months to make your selection. The earlier you start researching , the better. Once you choose an MCO — by calling the state’s toll-free number at (800) 859-6631 or enrolling via e-mail at [email protected] — you are committed until 2002. You want to be reasonably sure that you can forge a good working relationship with the MCO.
Look at track records. Visit the Web site of the Ohio Bureau of Workers’ Compensation at www.bwc.state.oh.us. It is a great resource on workers’ compensation, with a list of certified MCOs and the state’s report card, which scores MCOs on everything from number of claims to return-to-work ratios.
Talk to colleagues. Confer with business associates and human resources professionals to find out what they hear about a particular MCO. Word of mouth often is a solid gauge. Also, ask the MCO for references, then check them out.
Make communication a high priority. Consistent, high-quality communication is crucial to effective claims management. The MCO needs to keep you informed about the treatment and progress of injured workers, as well as provide firm return-to-work dates. How often and in what manner will they communicate with you?
Consider location. Depending upon your needs, a local connection might be important. A local MCO might have case managers nearby and can make on-site visits as necessary.
Know the differences. Not all MCOs are alike. Many function as third-party administrators, while others are true managed care organizations that work with networks of physicians and other health care providers within and outside workers’ compensation.
Know what you want. Does the MCO have everything in-house — from claims management to occupational health programs? Or, does it farm out some services? Consider whether you are willing to deal with middle persons.
The more thorough and painstaking your approach to the process now, the better off you will be over the next two years.
Stephen Elkins has served as director of Premier Comp, the managed workers’ compensation product of HomeTown Health Network and is director of sales for HomeTown, which has offices in Massillon and Akron.