What is a managed care organization?
A managed care organization (MCO) is a health care provider, or group of medical service providers, that contracts with insurers or self-insured employers to provide managed health care services to enrolled workers. Health care services are provided through participating panel providers.
MCO enrollment
The insurer may enroll you in the MCO at any time after your injury. Until you are enrolled in the MCO, you may treat with any health care provider who qualifies as an attending physician and is willing to accept workers’ compensation patients.
Your doctor may continue to treat you if your doctor obtains temporary credentialing from the MCO and agrees to the MCO’s rules, terms, and conditions.
- You must choose a doctor from the MCO panel, with some exceptions. For example, you may be able to continue to see a provider with whom you have an established relationship.
- The insurer should notify you if the insurer enrolls your claim in an MCO. To check if your claim is enrolled in an MCO, contact the insurer directly.
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