The Ohio Bureau of Workers’ Compensation (BWC) provides for an Alternative Dispute Resolution (ADR) procedure in the case of a medical case management dispute with the Managed Care Organization (MCO).
If the Provider, Employer, Employer’s Representative, Injured Worker, or Injured Worker’s Representative disagrees with a medical decision made by the MCO, that party must file a notice of dispute in writing to the MCO within fourteen (14) days of receiving notice of the MCO decision. The MCO has twenty-one (21) days from receiving your notice of dispute to respond outlining the reasons for their decision.
If the party is still in disagreement with the MCO’s final decision, the disputing party must notify the MCO in writing within seven (7) days of receiving the final decision from the MCO that he or she wishes the dispute to advance to the next level, which is with the BWC.
For Health Management Solutions, send notice of any medical dispute to:
Health Management Solutions
2545 Farmers Drive Suite 400
Columbus, OH 43235
For questions regarding medical disputes and/or the ADR process please contact:
Melissa Hennessey at 800-659-4025, ext. 290.