More MCO Madness

We are currently working with the client to file a denied claim through hearing, finally prevailing. Last fall, the employer accepted the claim, and in the last several months, our client has been searching for and MCO approved physician.

An MCO is a "Managed Care Organization." Oregon Workers' compensation carriers are allowed to contract with MCO's to manage medical care. In order to get medical care through an MCO, an injured worker must treat with a physician who is a member of the MCO.

Unfortunately, many of the rural areas of Oregon are underserved by MCO physicians. Even physicians that are a member of the MCO refuse to treat injured workers, probably because their sic of the hassle and outright bullying they get from the MCO. As a result, injured workers have little or no choice of all MCO approved physicians, and face yet another layer of bureaucracy in obtaining medical care.

Hopefully, the Workers' Compensation Division will look reforming this long broken system. It is probably doing more harm than good.

Be the first to comment!
Post a Comment