For Employers
Employer FAQ
Answers to the questions Ohio employers ask most about managed care and workers’ compensation.
What is the difference between an MCO, a TPA, and the BWC?
The Ohio Bureau of Workers’ Compensation (BWC) is the state agency that manages Ohio’s workers’ compensation system and determines claim allowances. A Managed Care Organization (MCO), like Spooner MAI, is a company employers contract with to medically manage claims and reduce costs. A Third-Party Administrator (TPA) is hired by employers to represent their interests, contest claims, and recommend cost-saving programs.
What should I do if an employee is injured?
Report the injury to Spooner MAI immediately. After the claim is filed, a Claims Analyst follows up on return-to-work status. Severe injuries may be transferred to Case Management with a Nurse Case Manager. Our staff stays in contact throughout the life of the claim to help your employee recover and return to work.
What are my responsibilities for claims in the $15K program?
Under the $15K Medical Only program, employers pay medical bills within 30 days, notify the BWC when the $15,000 limit is reached, maintain injury records for six years, and report claims to Medicare when required. You can opt out at any time, and Lost Time claims automatically exit the program.
How do I report a fraudulent claim?
Suspected fraud can be reported through the BWC’s online Fraud Allegation Form or by calling the hotline at 1-800-OHIOBWC. You may provide confidential information including the suspect’s name, details of the fraudulent activity, and relevant circumstances.
Ready to lower your workers’ compensation costs?
Choosing Spooner MAI as your Ohio BWC Managed Care Organization costs you nothing extra — and our best practices can save you significantly while returning employees to work faster.