Managed Care

MCO Best Practices

MCO Best Practices
Reading time 4 Mins
Published on May 10

When it comes to selecting a managed care organization (MCO) to provide medical management for your workers’ compensation claims, keep in mind that not all MCOs are created equally. While MCOs are required to perform the same basic functions, Sheakley UniComp has developed a streamlined program that ensures our services are always second to none.

Here are just a few examples of the processes we employ to deliver performance excellence to our clients and their injured workers.

The Importance of Early Reporting

The most important step that can be taken to ensure the best outcome for a claim is for the injury to be reported as early as possible. We continually stress to our clients how important early reporting is in helping workers get the treatment they need and in addressing possible safety issues in the workplace.

We work with our clients to outline specific plans of action should an accident occur. We ensure supervisors and employees have access to the forms necessary to report an injury as soon as possible. Early reporting allows our case managers to facilitate the medical interventions that injured workers need more quickly, thus expediting an eventual return to work. Additionally, the sooner we receive the details of a claim, the sooner we can begin evaluating the initial cause of the accident and make recommendations to prevent similar incidents in the future.

A Network of Care

Injured workers are encouraged to seek emergency medical intervention from any local provider in the immediate aftermath of an injury. However, once a claim has been filed, the worker must begin receiving treatment from a BWC-approved provider.

At Sheakley UniComp, we have worked to create a network of medical provider relationships that allows us to refer our clients’ injured workers to doctors, therapists, and other specialists with experience in treating a variety of workplace injuries — with savings of up to 20% below the BWC fee schedule.

Additionally, our case managers can leverage these provider relationships and work collaboratively with medical staff to develop treatment plans that return injured employees to full duty faster.

Collaborative Communication is Key

We believe that consistent, proactive communication is essential for positive outcomes. Our Client Relations Managers (CRMs) maintain regular contact with clients to ensure that they’re kept up to date on the status of claims and employee treatment.

Additionally, our claim system tracks the history of the most common types of injuries, identifies specific areas of the workplace where employees are more prone to injury, and helps identify positions in which employees are more likely to sustain an injury. All this data is compiled and provided to clients to help them avoid future injuries and keep claims costs lower.

Return-to-Work Strategies That Work

We have developed a variety of return-to-work strategies that help injured employees during their recovery period and reduce claims costs for employers. Our programs even allow employers in physically demanding industries to get their injured workers back to work quickly and safely.

Our modified duty off-site option places injured workers in light-duty roles at local nonprofits during their recovery period. These positions allow employees to stay engaged and connected to the workforce, reducing the likelihood of total disability or lost time claims that can negatively impact an employer’s workers’ comp premium.

Choose an MCO That You Can Count On

Are you confident that your current MCO is developing and using its own set of best practices? If not, it’s important to choose an MCO that does. With open enrollment in full swing, now is the time to evaluate your options and select an MCO that best fits your company’s needs.

Learn more about Sheakley UniComp and how we can help get your injured workers back to work quickly and safely. To select us as your MCO, complete and submit our enrollment form by May 26.

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