05/24/2023
Workers’ Compensation MCO Open Enrollment
Workers’ compensation premiums are a significant overhead expense for employers. Navigating the claim process can also be complicated and frustrating for both the employer and an injured employee. But both are controllable, and your Managed Care Organization (MCO) is a key partner in achieving success with your workers’ compensation program.
Graphic Media Alliance endorses Sedgwick Managed Care Ohio for our members, and here are the two most important reasons why we encourage members to select Sedgwick MCO:
Results – the data is clear
- Claims managed by Sedgwick MCO incur 10.9% fewer lost days per claim than claims managed by other MCOs.1 Fewer lost workdays translates to less costly claims and fewer staffing problems to solve.
- Sedgwick MCO reduced medical costs for their clients by an additional 17.2% below BWC fee schedule in 2022.2 All MCOs reduce medical bills to the BWC standard fee schedule, but this additional Sedgwick reduction enhances premium savings and discount options.
Service – making things simple
- Workers’ compensation claims can become complex. Sedgwick MCO works closely with their client employers and with the injured employee to navigate the BWC system and the medical treatment process until the claim is resolved.
Now is the time to make a MCO selection. If you are already enrolled with Sedgwick Managed Care Ohio, no action is required. But if you are interested in improving and simplifying your workers’ compensation program, we encourage you to take this opportunity to engage Sedgwick MCO. Open enrollment end May 26!
Click Here to enroll and learn more about the value of partnering with Sedgwick MCO’s managed care team. You can also contact Sedgwick MCO by email at ClientServices@Sedwgickmco.com or by phone at 888-627-7586.
1 BWC Public Data 22-05025, 2021-2022 claims as of 12/13/2022
2 Sedgwick MCO Billing Data, Bills processed in 2022
Managed Care Best Practices for Recordkeeping, Documentation and Injury Reporting
Source: Sedgwick MCO, May 11, 2023
The month of May is Open Enrollment – an opportunity for Ohio employers that have state-funded workers’ compensation coverage to select their Managed Care Organization (MCO).
Recordkeeping and Documentation
One of the roles of an MCO is to collect the essential data elements of a workplace injury to initiate a workers’ compensation claim. Depending on the approach to collecting and arranging this information, the MCO can be an excellent warehousing partner for injury-related data.
Sedgwick MCO provides clients are a series of value-added reports designed to facilitate record keeping obligations of OSHA and PERRP. Many report options include an ongoing tally of lost workdays associated with each claim, as well as the number of modified duty workdays. Access to this information on a monthly, quarterly and especially an annual basis (early January) can help employers complete their OSHA 300 and PERRP posting that is due each February.
MCOs should also be able to account for additional datapoints to help determine whether a workers’ compensation claim is OSHA-recordable. For example, if medications are prescribed in the treatment of a workplace injury, it may be OSHA recordable despite having incurred no lost or modified workdays. Similarly, if treatment for an injury includes services that exceed what is considered first-aid in nature, the injury may also be recordable despite involving no lost time. An example of this would be a laceration that involves stitches, but the employee returns to work immediately. Referencing medical billing codes to identify specific covered treatments can be a simple way to gather information that simplifies the OSHA and PERRP reporting process.