Managed Care

MCO Qualifying Questions

MCO Qualifying Questions
Reading time 4 Mins
Published on May 3

Every two years during MCO Open Enrollment, the BWC allows Ohio employers to choose a new managed care organization. An MCO partner is invaluable in helping injured workers get the care they need, while also helping employers control the costs of their claims. Since employers are locked into their decision until the next enrollment period, it is important that they evaluate each MCO and choose the one that best fits their specific needs.

As you consider your options during this year’s open enrollment, here are a few questions you should ask to help select the right MCO partner for your company.

How quickly are you able to get injured workers back on the job?

While no MCO can give you an exact timetable for how long it will take to return an injured employee to work, your MCO should approach every claim with the ultimate goal of returning workers to active employment as soon as possible.

At Sheakley UniComp, our case managers collaborate with employers to identify alternative work arrangements, including modified-duty nonprofit and transitional work assignments, that will allow injured employees to remain productive and engaged during their recovery periods.

Consistent communication with the medical provider(s), injured worker, employer, and all other interested parties throughout the claims process allows our team to act quickly when an employee is medically cleared to return to work with restrictions, and then subsequently to regular employment.

What strategies do you utilize to help an injured employee return to work?

Unfortunately, there is no “one-size-fits-all” return-to-work strategy that will be suitable for every situation. Our Sheakley team utilizes a combination of modified-duty offsite nonprofit, transitional work, light-duty, and onsite modified-duty assignment options to facilitate a quick and safe return to work for injured employees.

For employers in high-risk industries such as construction and manufacturing that find accommodating injuries difficult, our modified-duty offsite programs offer solutions to limit the lost-time cost of a claim. This assignment option allows the employee to return to work at a local nonprofit at their pre-injury wage, effectively eliminating any further lost-time portions of the claim.

How can you help my business save money on my workers’ comp premiums?

Since current year claims are the basis for next year’s premiums, effective medical management of claims can have a significant impact on your future premiums.

Sheakley UniComp’s extensive provider network allows our clients to access rates up to 20% below the BWC fee schedule. Our industry-leading return-to-work strategies further reduce costs by drastically decreasing or eliminating lost-time claims by getting injured workers back on the job quickly. Additionally, our drug utilization review procedures help mitigate the likelihood of post-injury drug abuse and can help to prevent future claims.

Can you list three medical providers located near my business?

MCOs can have a substantial impact on the medical costs of an employer’s workers’ comp claims. An MCO with a strong provider network ensures that its clients and their injured employees always have access to high-quality medical care with professionals who are experienced in handling workers’ comp injuries.

At Sheakley, we negotiate provider rates for our clients that are far below the current BWC fee schedule. Lower medical costs mean less impact on your experience rating factor and, in turn, controlled premium increases.

Can I get a few client references?

An MCO that delivers consistently exceptional service and support will have customers in their corner willing to champion their cause to prospective clients.

Sheakley UniComp provides a minimum of 3 client references that prospective clients may contact to ask questions and gain insight into the service that we provide. Additionally, we provide letters of recommendation and links to client testimonial videos that we’ve had the opportunity to create.

Weigh Your Options and Choose the Right MCO

Now is the time to pick a new MCO, and picking the right one for your business is essential. If you aren’t getting clear answers, unique insights, and a commitment to excellence from your current MCO, it might be time to switch.

Are you ready to learn more about Sheakley and see if we are the right fit for your company? If the answer is yes, discover the Sheakley UniComp difference here. Then come back and complete our Open Enrollment form to select us as your MCO partner.

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