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Providence MCO - How We Manage Care
Providence MCO strives to build healthy workplaces through better partnerships in business and industry. Below is a checklist of key "tools" we offer insurers and self-insured employers.
- A philosophy based on providing the most cost-effective use of health care resources that produce the best outcomes, with a focus on early return to work.
- A select panel of physicians who meet tough credentialing standards and have agreed to partner with Providence MCO and employers to provide injury care within a managed care framework.
- A utilization / quality management program that determines when surgical and non-surgical care is appropriate and ensures that quality managed care is provided.
- A dispute resolution process designed to resolve issues pertaining to medical care or contract violations, giving each person involved a fair means of resolving conflict.
- A close partnership with the employer or claims adjuster to facilitate the best use of MCO resources that focus on keeping the injured worker on the job during the recovery process.
- A full complement of customer service resources such as provider directories, toll-free customer service lines, client training programs, referral assistance and other consulting services.
- A case management program that focuses on issue-specific intervention provided in conjunction with the claims staff and physician.
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