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Providence MCO - Benefits
A managed care approach to injured-worker treatment offers quality medical services that are easily accessible and convenient.
Providers participating in the program have an interest and expertise in occupational medicine. They are partners in reducing unnecessary costs associated with treating work injuries. Providers use treatment guidelines that promote aggressive management and support an early return-to-work strategy that allows the worker to remain in a productive environment while recovering. MCO tools that make this possible include:
- Provider selection and credentialing process assures that providers meet established criteria and agree to the program's early return-to-work philosophy and treatment guidelines.
- Preferred scheduling for specialty care appointments
- Managed chiropractic services
- Second opinion program
- Dispute resolution and appeals process that is efficient and fair
- Ability to enroll most claims in the MCO program (existing, new and closed claims).
- Utilization management programs – hospital stays and procedures are determined medically necessary by established criteria.
- Occupational medicine clinics designed to meet all the occupational health needs of an employer.
- Discounts for inpatient and outpatient facility services, occupational health clinic and urgent care services.
- Overall reduction in medical time loss and litigation costs
- Medical treatment review process
LifeBalance
Recreational discounts on cultural activities and events.