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Managed Care Organizations
Many States have enacted legislation for workers’ compensation to offer a certifiable managed care program designed to more closely manage workers’ compensation injuries and costs. Coventry Workers' Comp Services (“Coventry”) provides MCO services in a number of states where MCO programs are supported by statute. Our MCOs are designed to manage medical costs and return-to-work outcomes without compromising quality of care. In addition, Coventry monitors legislative and regulatory changes in these states in order to ensure continued compliance and to identify opportunities to improve outcomes. Coventry offers two types of programs for MCOs:
- In our fully bundled program, we act as either the certified entity or the support for a client's certification by supplying all the services under the MCO regulations. We provide fully bundled MCO services in the following states: CT, FL, GA, KY, NE, NJ, NY, OK, TX HCN and WV.
- In our network only program, we provide all appropriate network documentation to support a client's certification. We provide network-only MCO services in the following states: AR, CT, CA, FL, GA, KY, MA, MT, NE, NJ, OK, SD, TX and WV.
Key Information Clients Should Know:
- Coventry uses participating providers in the Coventry, First Health, FOCUS or MetraComp Networks in the MCOs in applicable states.
- Clients should direct all network providers with questions about their services, contract, rates, etc. to Coventry’s provider Services number at 800-937-6824.
- Need More Information?
- For additional information regarding MCO requirements and regulations, please select your state from the state overview drop-down located on the right side of the page and click the Web Resources link
- FOR IMMEDIATE ASSISTANCE CALL 1.800.342.5888
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OUR NETWORK INCLUDES
- The First Health Network
- A component of the Coventry Integrated Network offering >>
- Exclusive Provider Networks
- Our EPN model is a smaller network focusing on positive outcomes >>
- Managed Care Organizations
- Two types of MCO programs help clients comply with state-specific regulations >>