For Employers
Workers’ Compensation Managed Care Policies & Procedures
A guide to how managed care works under the Ohio Bureau of Workers’ Compensation — and the role every party plays in a well-managed claim.
Getting Started
All workers must receive an identification card from their Managed Care Organization. Spooner MAI supplies these cards to employers with the essential contact information for reporting and managing a claim.
When an Injury Occurs
Early reporting is critical. When an injury happens, help the employee complete an injury report, select a provider, and present the Spooner MAI identification card to the medical professional. Prompt reporting speeds recovery and reduces cost.
Choosing a Medical Provider
An injured worker may seek treatment from any Ohio Bureau of Workers’ Compensation (BWC) certified physician. Spooner MAI can provide referrals during business hours, Monday through Friday, 8:00 AM–5:00 PM.
Submission of Claims
The claims process remains the same as existing procedures. Spooner MAI verifies the information and submits the claim to the BWC for a determination of allowance.
Payment of Medical Bills
Medical bills for allowed claims are covered. If a worker has paid out of pocket for treatment from a BWC-certified provider, they may seek reimbursement.
The Role of Employers in a Return to Work Program
Employers provide job-capability information to medical providers and support modified-duty arrangements so employees can return to work safely and as soon as medically appropriate.
The Role of Spooner Medical Administrators
Spooner MAI handles pre-certification of treatment, utilization management, and quality assurance — coordinating between the injured worker, employer, physician, and the BWC throughout the life of the claim.
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.