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OhioBWC - Provider: Managed Care Comes to Ohio For Health-Care Provider
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Managed care comes to ohio
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| For health-care providers |
Health-care providers must be BWC-certified to participate in the Health Partnership Program (HPP) or a Qualified Health Plan (QHP). You may belong to multiple managed-care organization (MCO) or QHP panels.
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Provider enrollment and certification is ongoing. To enroll
you must:
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- Provide current license to practice;
- Provide valid Drug Enforcement Agency registration;
- Have no previous termination from BWC, Medicare or Medicaid programs;
- Have no felony convictions;
- Prove adequate malpractice coverage;
- Provide other specific provider-type requirements.
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In QHP, you may contract with the MCO or directly with the employer to
provide services. Also in QHP, all terms are negotiated with employers. Financial
arrangements cannot negatively impact the quality of services provided.
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For your convenience BWC has provided a PDF version of our application
to become a BWC-certified provider, to download, print, fill in and mail to
BWC.
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You will need the Adobe Reader to display and print
this form. To download
the Adobe Reader, click here and follow the
instructions.
Download the application to become a BWC-certified provider.
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If you have questions about the provider-certification process,
please call 1-800-OHIOBWC and follow the options Monday through Friday 8 a.m. - 4:45 p.m.
eastern time.
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As a BWC-certified provider, you play an important role in the
reporting of injuries. Whenever you treat injured workers, ask them who their MCO is.
If they don't know who their MCO is, you can help them find it
through Employer/MCO Lookup or
by calling 1-800-OHIOBWC, and follow the options.
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| By rule, you must report an injury to the appropriate MCO within 24
hours or one business day of the initial treatment or initial visit. MCOs rely heavily
on you to provide all the
BWC required information for a First Report
of Injury (FROI).
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