Important Managed Care Information

Response to COVID19 – In an effort to support our medical providers and injured workers during the COVID-19 pandemic, MSMM is making available Telehealth services as a safe alternative to visiting a medical care provider’s office.  Please contact your claims representative to explore this safe and easy treatment option.

For all states except California, to find a medical provider near you through the Corvel website, visit this page or download their app for remote access.

For California, to find a medical provider near you through the Corvel website, visit this page or download their app for remote access.

Alternatively enter your email address here for access and to create a formal panel of physicians. (Please note an instant automatic reply will be sent to your email address with the login information).

Workers’ compensation varies in each state. To learn more about important programs and updates, find your state information below:

• California Workers’ Compensation Required Reporting for First Aid Claims (english/spanish)

• California Medical Provider Network (CA MPN) – CorVel Corporation

  For California, to find a medical provider near you through the Corvel website, visit this page or download their app for remote access.

  Alternatively enter your email address here for access and to create a formal panel of physicians. (Please note an instant automatic reply will be sent to your email address with the login information).

  • Email

  The new CA MPN has been approved by the California Department of Industrial Relations to treat workers injured on the job. Experience has shown that medical outcomes for injured workers can be improved when employees are given a choice of provider(s) in an approved medical provider network.

  The CA MPN offers a wide range of benefits, including:

  • Earlier return to work – state documented
  • Lower medical costs – state documented
  • Reduced litigation through internal dispute resolution process
  • Access to care within 24 hours
  • Limited provider change once enrolled in program
  • Limited initial provider selection. Employee risks suspension of compensation benefits if treatment is received from a non-network physician
  • No ceiling on control of care, as long as specialty is certified
  • Network discounts
  • Utilization review is mandated

  
  NOTE: MSIG urges all policyholders to participate in our MPN. Utilization of this program provides an excellent opportunity to control workers’ compensation costs, while simultaneously providing quality medical care to your injured workers

  How to Get Started Utilizing the MPN

  POST at each work site:

  • MPN provider panel
  • DWC-7, which includes MPN-specific information
  • Pre-designation of personal physician form

  How to Transfer From One MPN to Another MPN

  CA MPN End of Coverage and Implementation Notice must be distributed:

  • To all injured workers when changing from an existing MPN to another MPN within 60 days.
  • To all employees when changing from an existing MPN to another MPN if more than 60 days have lapsed since ceasing use of a prior MPN.

  POST at each work site:

  • MPN provider panel
  • DWC-7, which includes MPN-specific information
  • Pre-designation of personal physician form

  MSIG will provide the Complete Employee Information notice (0056 Mitsui Sumitomo Ins of America or 2039 Mitsui Sumitomo Ins USA) to the employee once the injury has been reported to MSIG. This will serve to educate the employee regarding the MPN and advise the employee how to access the MPN network.

  CorVel Corporation may be contacted via:

  MPNaccess_Hotline@CorVel.com

  The MSIG Claims Office in Los Angeles, CA, can assist you with any questions.Please contact one of our representatives at (800) 365-4671. Press 3 to reach the Workers’ Compensation Claim Department.

  Please click on the links to the following forms that are available for your use:

  Standard Claims and MPN Materials:

  • Report a Claim: Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility
  • Post at Workplace: Notice to Employees – Injuries Caused by Work (DWC 7): 0056 2039
  • Provide at Time of Injury: Complete Employee Information Notice – 0056 Mitsui Sumitomo Ins of America – 05: (English & Spanish versions)
  • Provide at Time of Injury: Complete Employee Information Notice – 2039 Mitsui Sumitomo Ins USA – 06: (English & Spanish versions)
  • Make Available as Requested: Pre-designation of Personal Physician (English & Spanish versions)

  Optional Kaiser MPN Documents

  • Report a Claim: Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility
  • Post at Workplace: Notice to Employees—Injuries Caused by Work (DWC 7): 2389 2390
  • Provide at Time of Injury: Complete Employee Information Notice — 2389 Mitsui Sumitomo Ins of America — 05: (English & Spanish versions)
  • Provide at Time of Injury: Complete Employee Information Notice — 2390 Mitsui Sumitomo Ins USA — 06: (English & Spanish versions)
  • Make Available as Requested: Pre-designation of Personal Physician (English & Spanish versions)

• Illinois Preferred Provider Program (PPP) and Employee Information

  Dear Policyholder:

  Under the Illinois workers’ compensation system, employers can create Preferred Provider Programs (PPP) for workers’ compensation. MSIG is offering the availability of a PPP for our policyholders. To assist you in complying with the new regulations, we are providing the PPP Employee Notification Packet.

  Here’s what you need to know:

  • If enrolling in the PPP, it is mandatory for the employee to receive a complete copy of the PPP Employee Notification Packet at the time the injury is reported. This packet contains the following.
    • Employee Notification Letter – Exhibit B — mandatory to distribute at the time the injury is reported
    • Employee Acknowledgment Signature Form (recommended) – Exhibit B-1 — used with PPP Employee Notification Packet (Exhibit B)
    • Employee Opt-Out Form (recommended) — Exhibit C — to be completed by employer, provided to MSIG claims adjuster. MSIG to provide to CorVel
    • Spanish Employee PPP Notification Packet

  Finding an Illinois PPP Provider

  Opt-Out Tracking

  If an employee does not want to use the PPP, he or she must notify the employer in writing. Employer/policy holder should keep an active log of opt-out notices received. Please notify MSIG if the injured worker has opted out. This is very important to the claims handling process to ensure appropriate care is provided.

  At MSIG, we believe that timely, early reporting of a claim is the best approach to containing your workers’ compensation costs and assuring your employees receive appropriate medical care. Participation in the PPP will help support medical cost containment and facilitate prompt return to work. If you are interested in participating, please notify MSIG.

  Attachments:

  • IL PPP Policyholder Letter

  PPP Program Goals and Objectives:

  • To ensure that the injured worker receives quality, cost-effective medical care
  • To ensure that medical care is geared toward expedient recovery
  • To ensure appropriate steps are taken regarding hospitalization
  • To ensure an appropriate discharge plan
  • To channel injured employees to the PPP providers and physicians
  • To return the employee back to work as quickly as medically feasible

  The PPP Helps Injured Workers:

  • Receive quality, cost-effective medical care
  • Expedite their recovery
  • Receive the appropriate hospitalization care
  • Ensures an appropriate discharge plan
  • Receive access to the network providers
  • Ensure a timely return to work

  Employer Advantages:

  • Manage cost and improve care
  • Reduce medical payout
  • Provide lifetime medical control of the claim
  • Ensure timely recovery and return-to-work outcomes
  • Ensure shorter TTD durations (Temporary Total Disability)
  • Provide assistance with implementation

• New York Workers’ Compensation

  Important Announcement — to Our New York State Workers’ Compensation Policy Holders:

  The New York State Workers’ Compensation Board Rule 300.37 mandates that a New York employer provide a “Claimant Information Packet” to an injured worker at the time of the injury.

  To assist you in complying with this mandatory regulation, you can download the Claimant Information Packet, here.

  This requirement applies only to New York State workers’ compensation claims.

  If you have any questions, please contact:

  Email: CustomerService@msigusa.com

• Texas Health Care Network (HCN)

  Texas House Bill 7 was signed into law on June 1, 2005. This law allowed for the implementation of health care networks on or after January 2006.

  Since partnering with CorVel Corporation, the CorVel Texas Health Care Network (HCN) has been available to MSIG customers. The CorVel HCN offers widespread coverage in the densely populated areas of Texas.

  To begin the enrollment process and request assistance, contact our customer service number at (866) 676-6272. To learn more about HCN or for further assistance in the enrollment process, please refer to the following links:

  • Employer Posting
  • UR Appeals
  • Texas CorCare Network Guidelines
  • Employee Information Packet PowerPoint
  • Texas HCN Presentation for Agents-Employer

  2014-01 Texas CorCare Network Requirements (Separate Acknowledgement forms available as well)

  • Network Requirements (English/Spanish)
  • Acknowledgement Form (English/Spanish)