MEDICAL PROVIDER NETWORKS (MPN) — California
Beginning January 1, 2005, Insurers and Self-Insured Employers in the state of California have a new opportunity to control runaway medical costs by employing a Medical Provider Network (MPN).
An MPN is a network of medical professionals who will provide medical care for employees who have suffered a work-related injury or illness. MPN's are regulated by the California Division of Workers' Compensation (DWC) and must meet certain standards to be approved. MPN providers are requred to follow the medical treatment guidelines established by the DWC. Employees subject to an MPN are required to treat with MPN pysicians for the entire life of a claim.
Medical provider networks have been created in an effort to streamline medical delivery to injured workers for workers' compensation injuries and illnesses. The basic components of Medical Provider Networks are an exclusive medical provider panel, medical oversight and direction, communication tools that assist the injured employee in getting prompt access to medical treatment and communication tools that provide claims administrators with medical determinations and treatment plans.
CompPartners is a certified Health Care Organization (HCO) in the state of California and will begin offering MPN services starting January 1, 2005. CompPartners' MPN provides comprehensive, statewide medical access and has the best point-of-entry providers in the state of California -- those that know how to treat a workers' compensation injury and know that getting the injured worker well and back to work is the primary goal. We believe that quality medical treatment is the key to success in workers' compensation.
In our experience, most injuries can be treated by an occupational specialist who can see employees in an expeditious manner. The more serious type of injuries need more intensive treatment and should be assisted through the medical process with expedited appointments and, in some cases, nurse case management.
When working inside an exclusive provider network, we have had significant success utilizing telephonic nurse case managers who integrate utilization review and medical/disability management, including return-to-work services. All of this work is communicated to the claims organization, providing claim administrators with the data they need to make payments on the claim and bring the case to closure in a timely and effective manner.
As an option, your program can include an early intervention service, provided by CompPartners. We are experienced in the review of all first reports of injury to make sure the injured employee is treating within the MPN network and at the appropriate level of care.
We will be happy to work with you to customize a program that meets your specific needs. For more information on how we can create an MPN solution tailored to your specific needs, call us at (949) 253-3111.
CompPartners is uniquely positioned to provide your MPN solution
• CompPartners Management Team is among the most experienced in utilizing Managed Workers' Compensation Provider Networks.
• As an approved HCO since 1998, CompPartners can handle the entire MPN application process on your behalf.
• Wide selection of Medical Providers covering all counties and required medical specialties from which you can create your customized MPN provider panel.
• Experienced in Direct Channeling of employees to MPN providers.
• Experienced staff in providing MPN-required employee notifications.
• Integration of CompPartners Early Intervention, Case Management and Utilization Review processes available at your request.
• Fully compliant with all aspects of the new law.
For more information on how we can create an MPN solution tailored to your specific needs, call us at (949) 253-3111.