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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).

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.

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 to ensure compliance with URAC standards and assess the quality of treatment reimbursement decisions 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.

"Premier Comp has a service-oriented philosophy. They care about you and your employees and add value to your business. . . Premier Comp has definitely helped us to reduce lost days."--Randall A. Hutsell, president of Electra Cord, Inc., in Massillon, whose workforce of nearly 100 people manufactures and assembles power supply cords for the appliance industry

Consumer Bill of Rights

The purpose of the "Bill of Rights", is to safeguard the individual's rights while assisting and identifying medical and vocational goals and barriers. The consumer and their support system(s) have the right to:

Expect strict confidentiality, security and personal privacy of consumer specific information, including medical records
Know the process by which consumers are informed of choices regarding services
Appeal treatment reimbursement decisions
Education regarding the nature of the Case manager's role and responsibility to the consumer, employer and Ohio Bureau of Workers' Compensation
The circumstances in which information obtained in the Case Management relationship will be disclosed to third parties
Be notified in writing of Case Management actions and recommendations
A complaint process
A description of the rationale for selecting consumers for Case Management services
Refuse Case Management services without loss of Workers' Compensation benefits
Obtain information regarding Premier Comp's criteria for Case closure
Have input into the Case Management plan
Receive notification and a rationale when Case Management services are changed or terminated
The use of end of life and advance care directives honored
The use of alternative approaches when the consumer and/or family is unable to fully participate in the assessment phase

Transitional Work Grants

The Ohio BWC is offering Transitional Work Grants to assist employers in developing and implementing formal transitional work programs. Transitional work is a return to work program which includes implementing policies and procedures to ensure that injured workers return to customized work safely and are "transitioned" back to their regular job duties. Through implementation of a transitional work program, employers can help lower Workers' Compensation costs by reducing indemnity or compensation payments.

Premier Comp recommends that ALL employers take advantage of the Transitional Work Grants offered by BWC. Employers can receive reimbursement for 100% of the cost of developing their own transitional work program with the help of a certified transitional work developer. Grant development may include creation of a multiple job analysis and identifies specific jobs and duties that would be available to injured workers on restrictions. The program also helps the employer utilize strategies that will reduce lost time and ultimately decrease costs.

Premier Comp will be happy to assist you with your transitional work program. Please call 800.776.4771 to get started today!

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.