Evaluating Ohio Managed Care Services

Every two years the Ohio BWC produces an MCO Report Card that is available to every Ohio employer. This report has a lot of statistics related to Workers’ Compensation “claims processing” and comparisons between all MCO’s.

This information is interesting, however, it does not include the basic customer service quality values an employer should be concerned about. We have outlined some MCO quality questions for an employer to consider:

1. Do you receive timely and informative notification of a reported claim from your MCO claims representative?

2. Do you work with a consistent claim representative that manages all of your active claims and is aware of your work environment and return to work policies?

3. Is your claim representative “pro-active” in managing your claims and persistent in achieving an objective return to work outcome?

4. Does your MCO assist you in understanding the Ohio BWC system?

5. Is your MCO assisting you in managing claims in a objective and cost effective manner?

These are the issues that directly relate to satisfaction with your Workers’ Compensation managed care service. The BWC report card will show you how one MCO compares in size and volume to other MCO’s in addition to claims processing statistics. A lot of the statistical averages are skewed based on the variance of claims processed between large and small MCO’s.