The MCO Policy Reference Guide is available on this Web site for any of BWC’s customers. The manual is updated quarterly to provide information about policies and procedures for BWC and MCO staff.

Note: If you have arrived on this Web page as a result of a search engine (or other) link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the materials unless you read, agree to and abide by the provision of the copyright statement. Read the copyright statement now.

For your convenience, you can download and print a specific chapter or the entire manual from this Web page. The free Adobe Reader software is required to display and print publications that are available for viewing online.

To download a specific chapter, click on the chapter title. If you want to download the entire manual, click on each chapter title and download each chapter one at a time.

• Table of Contents
• Chapter 1 – General Information
• Chapter 2 – Claims Management Information for MCOs
• Chapter 3 – Medical and Return to Work Management
• Chapter 4 – The Role of Vocational Rehabilitation in Ohio’s Workers' Compensation
• Chapter 5 – Medical Dispute Resolution
• Chapter 6 – Provider Relations
• Chapter 7 – Outpatient Medication Prior Authorization Program
• Chapter 8 – Coding and Reimbursement Standards
• Chapter 9 – Outcome Analysis
• Chapter 10 – Forms
• Appendix I – Provider Requirements for Enrollment
• Appendix II – 148 Data Element Timeframes
• Appendix III – Explanation of Benefits Table
• Appendix IV – Medical policy documentation guidelines

Policy alerts
BWC will periodically issue policy alerts to provide further clarification on specific policies. To download the latest policy alerts, click on any of the links below.

• Clarification of Appropriate Use of EOB 776
• Use of EOB 776 (PowerPoint presentation)
• Cardiac Clearance Medical Position Paper
• Global Surgical Care: Services Included in the Global Package
• Telephone Call CPT® Codes (99371-99373)