Some employers participate in a workers' compensation certified managed care plan. A certified managed care plan is an organization that has been certified by the state to manage health care for injured workers. An employer must tell an employee if they are covered by a certified managed care plan. Some employers or insurers have contracted with a managed care plan or network of doctors who are not certified by the department. Injured employees are not required to receive treatment from a doctor in a plan or network that is not certified.
There are three managed care plans certified under Minnesota Rules 5218.0100 to provide managed care for services for an injury or condition covered under Minnesota Statues Chapter 176, Workers' Compensation.
Contact: Employee Intake Nurse, 3001 N.E. Broadway Street, Suite 600, Minneapolis, MN 55413
Phone: (612) 436-2403 or 1-800-275-8893; fax: (612) 436-2499
Contact: GENEX/America's PPO, 440 E. Swedesford Road, Suite 1000, Wayne, PA 19087
Contact: Worksite Health, 8170 33rd Ave. S., 6 South, P.O. Box 1309, Minneapolis, MN 55440-1309
Phone: (952) 883-5396 or 1-888-779-3625; fax: (952) 853-8732
If you are covered by a workers' compensation certified managed care plan:
your employer must post a notice that shows how to get treatment using the managed care plan and provide the name and phone number of a contact person;
you may ask the employer, the insurer or the certified managed care plan staff for a list of providers in the plan; and
a medical case-manager might be assigned to coordinate the delivery of health care for your injury.
You must go to a provider in the certified managed care plan unless:
you need emergency medical care;
you want to be receive care from another health care provider who is able to treat your injury and has treated you at least twice in the past two years or who has a documented history of treating you; or
you live or work too far from a health care provider in the plan. (There is a 30-mile limit in the seven-county Twin Cities area and a 50-mile limit in all other areas.)