What if I am currently receiving care from a non-MCO provider for a work-related injury or illness at the time I am enrolled into the MCO program?
You will be required to treat with an MCO provider, with the exceptions noted above. However, if you have not yet been declared medically stationary, are required to change physicians, and the MCO determines that it would be medically detrimental for you to change physicians, you would not be subject to the MCO requirements until you become medically stationary or choose to change physicians, whichever occurs first. If you are not yet medically stationary and think that a change of physicians would be medically detrimental to you, you may request review of your situation by the MCO. To request review, please submit your request in writing to the address listed within 30 days of the date of the action. Failure to request review in writing within 30 days precludes further appeal.
Related Questions
- What if I am currently receiving care from a non network provider for a work-related injury or illness at the time I am enrolled into the HCN program?
- How do I decide whether an injury or illness is work-related if the employee is on travel status at the time it occurs?
- What should staff do if they have a work-related accident, injury, or illness which occurs at a telecommuting work-site?
