Managed Care Organizations And Workers’ Compensation

When you have been injured at work, you don’t want to have to find your way through a bureaucratic maze in order to have your medical bills covered. You want to focus on getting well and getting back to work.

But the workers’ compensation system in Ohio is quite complicated. Your treatment request may be evaluated both by the state and by a company called a managed care organization. At the Philip J. Fulton Law Office, in Columbus, we can guide you through the system effectively.

Getting Your Medical Bills Paid — So You Get The Treatment You Need

There are all sorts of injuries at work or occupational diseases that can land you in the hospital or under a doctor’s care. It might be an injury or illness that builds over time. Or you might have been hurt in a workplace accident.

Either way, issues can arise regarding what sorts of tests or services are covered by workers’ compensation. But making the case for getting the level of care you need gets complicated when the workers’ comp system doesn’t thoroughly understand your injury. This misunderstanding may be by the managed care organization.

In Ohio, MCOs collaborate with the state’s Bureau of Workers’ Compensation (BWC) to medically manage your injury and review your doctor’s treatment request, as well as pay bills. Your doctor will submit requests for treatment on a form known as the C-9 form.

If all of this sounds bureaucratic, it is. And as the process unfolds, you may need a strong legal advocate to make sure you get the treatment you need to recover from your injuries as fully as possible.

The Role Our Firm Plays In Asserting Your Claim

This is where our law firm comes in. We can use our many years of experience in these cases to advocate for you throughout the workers’ compensation claims process.

If a managed care organization has unfairly denied a treatment request, we won’t let that go unchallenged. We can pursue administrative remedies within the state’s Bureau of Workers’ Compensation (BWC). And, if necessary, we can file an appeal with the Industrial Commission.

We encourage you to get in touch today to discuss how we can help you in your specific case. Give us a call at 614-963-9569 or simply fill out our online contact form.