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What to Look for in an MCO
May 23, 2025
What is an MCO?
MCOs are contracted through the BWC to manage the medical aspect of employee work-related injury claims. They are paid by Ohio BWC with a portion of employer-paid premiums.\
What should an employer look for when selecting an MCO?
- A utilization review department that is separate from the case management department is key. This helps an MCO maintain impartiality and make objective decisions when responding to treatment requests by doctors to determine their appropriateness in the context of a claim.
- An MCO needs a comprehensive fee-auditing department to determine what claims are appropriate to pay. A company should feel confident that their MCO’s process is thorough enough to avoid unnecessary charges.
- Companies benefit from MCOs that have a relationship with a provider network. This enables it to take advantage of discounts below the BWC’s fee schedule. Lower medical costs equate to lower workers’ compensation premium payments.
- Customized reporting is an added perk, as such reports can contain incredibly valuable information - like how to target and engineer out certain injury types with better safety or ergonomic programs.
- A company should have one point of contact at their MCO. Having multiple contacts is confusing. One point of contact means the MCO can learn the employer’s preferences, and most importantly its return-to-work philosophy.
- MCOs should help with an employee’s return to work, and offer flexible return-to-work strategies that are specific to the employer.
For more information, contact Brandy King at
brandyk@suretyhr.com
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