Promptness in reporting the claim is a must!
As a BWC-certified provider, you play an important role in the reporting of injuries. Providers must report a worker's injury to BWC or the appropriate managed care organization (MCO) within 24 hours, or within one business day of the initial treatment or visit.
Note: If the injured worker's employer is self-insuring, report the claim directly to the employer.
How to report a claim
- Report the injury to the appropriate MCO.
- Determine the correct MCO either by asking the injured worker, using the Employer/MCO look-up, contacting the employer or BWC.
- The MCOs must successfully transmit first reports of injury to BWC after you notify them.
- Complete the First Report of Injury and receive the claim number instantly.
- Provide all information you've gathered related to the injury or disease.
- This facilitates a quicker determination of the claim and allows the MCO and BWC to process your bills and the injured worker's benefits sooner.
- Report the injury directly to the employer - self-insuring only.
- If you cannot determine the correct MCO or you know the injured worker's employer is self-insuring (SI), use this SI employer contact list to find out where to file the claim.
Communicating with the MCO
The MCO case manager will want to work closely with your office to facilitate appropriate treatment authorization, and to coordinate rehabilitation efforts and return-to-work goals by communicating with you and the employer.
The MCO Directory is a great tool designed to assist providers in contacting and communicating with the MCOs.
If you have additional questions about Ohio’s managed care programs, email BWC's provider relations department or call 1-800-644-6292 and follow the options.
Additional resources for reporting injuries