- How to Report an Injury
- Employer Responsibilities
- Premier Comp ID Card
- Services
- Transitional Work Grants
- Grievance and Dispute Process
How to Report an Injury
- Contact Premier Comp at 1.800.776.4771.
- Seek treatment from BWC-certified provider.
- Take a Premier Comp identification card to your medical provider.
- If you cannot reach Premier Comp, you may complete a First Report of an Injury form (FROI-1).
Employer Responsibilities
Employers can make a big difference by reporting injuries to Premier Comp immediately. The earlier Premier Comp is aware of an injury, the sooner we may begin investigating the injury and assist employees to the appropriate medical providers.
- Report all work related injuries to Premier Comp within 24 hours of notification.
- Assist Premier Comp in identifying required information for injury reporting.
- Communicate available return to work options such as modified duty and job descriptions.
- Educate employees on how to report injuries and seek medical treatment (Premier Comp may assist the employer in education of employees and supervisors).
- Distribute Premier Comp identification cards to all employees.
Premier Comp Identification Card
Premier Comp identification cards should be distributed to all employees and used for work-related injuries only. When an injured worker seeks treatment for a work related injury, he or she should present their identification card to assist in identifying the employer and MCO, therefore, expediting medical treatment and the claims process.
If you would like to order additional identification cards or have any questions or concerns, you may contact Premier Comp via email or by calling 1.800.776.4771. (Front and back of card shown below.)
Services
Case Management
Case Management is a collaborative process that assesses, plans, implements,
coordinates, monitors and evaluates options and services to meet a client's
health needs through communication and available resources to promote quality,
cost-effective outcomes.
Premier Comp is certified in Case Management by the American Accreditation HealthCare Commission (URAC). We have certified Case Managers (CCM) who work with injured workers, employers, and healthcare providers to perform the functions of Case Management. The ultimate goal in working with injured workers is to assist them in reaching an optimal level of functioning and wellness while achieving a safe and timely return to work. In working toward this goal, it is the Nurse Case Manager's responsibility to ensure that services are appropriate to the injury and generated in a time and cost-effective manner.
Vocational Rehabilitation
Vocational Rehabilitation is the process of restoring an individual’s ability
to work. Our goal at Premier Comp is to integrate Vocational Rehabilitation
services with your return-to-work policies to save money and reduce lost-time
days.
Vocational Rehabilitation is an individualized program for eligible injured workers needing assistance in safely returning to work or in retaining employment. Vocational Rehab emphasizes restoring or maximizing the injured worker's abilities and minimizing long debilitating absences from work.
Vocational Rehabilitation benefits employers by providing:
- Earlier return-to-work and reduction in lost time.
- Individualized return-to-work plans for your injured workers.
- Analysis of the job site and help in identifying modified work.
- Employer incentives and gradual return-to-work plans.
- Job retention services for injured workers continuing to have difficulty with job demands.
Qualified Health Plan (QHP)
Premier Comp is certified by the Ohio Bureau of Workers' Compensation to
provide managed care services to Ohio's injured workers. With this certification,
Premier Comp offers self-insured employers the ability to design and implement
a Qualified Health Plan (QHP) for employees injured on-the-job.
Self-insured employers may select from a menu of services or select Premier Comp to fully administer the plan, we are flexible in designing and implementing a plan that works best for you and your employees. Premier Comp offers the following managed care services:
- Provider Network Development
- Medical Case Management
- Vocational Rehabilitation
- Utilization Management
- Medical Bill Review and Payment
- Medical Dispute Resolution
- Quality Assurance
- Employer Education
- Management Reports
Quality Assurance
Premier Comp's quality improvement program monitors and evaluates the effectiveness
of Case Management and claims management. The Quality Assurance Committee
maintains and updates policies and procedures ensure compliance with URAC
standards and assess the quality of treatment reimbursement decision and
billing procedures in connection with approved treatment reimbursement.
Premier Comp's Quality Assurance Program is responsible to ensure quality
Case Management of Ohio's injured workers by tracking key quality indicators.
Grievance and Dispute Process
Grievance Process
Premier Comp has a process to resolve administrative issues or complaints
affecting the management of the claim or an employee. All complaints regarding
a Case Management issue or Administrative process should be directed to
Premier Comp. Managers will attempt to bring resolution within 48 hours
for all complaints or grievances. If grievances are not resolved to the
satisfaction of the customer, they may formally appeal the decision, in
writing, to Premier Comp within 14 days of the decision.
Premier Comp is required by the BWC to have an Alternative Dispute Resolution (ADR) process. ADR affords due process regarding conflicts in medical treatment issues. Disputed issues may include:
- Quality Assurance
- Utilization Review
- Determination that a service is or is not covered
- Treatment/service necessity
- Issues involving health care providers
Injured workers and their representatives, employers and their representatives, or providers may initiate ADR by contacting Premier Comp in writing. The disputing party should identify the issue with Premier Comp's decision, within 14 calendar days of receipt of written notice of an initial treatment reimbursement determination.
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