Frequently asked questions -- certified managed care

Questions

1. What is workers' compensation certified managed care?
Workers' compensation managed care plans are certified by the Minnesota Department of Labor and Industry, and provide for the delivery and management of medical treatment for injured employees through a network of health care providers.

An employee covered by managed care selects a treating doctor from the network, which must include medical doctors, chiropractors, osteopaths, podiatrists, physical and occupational therapists, and specialists. Somestimes the employer and managed care plan designate a clinic for the initial visit after an injury, but an employee may select any doctor in the plan for additional treatment that is needed. In some cases, the employee may be able to continue treating with a doctor outside of the network with whom the employee has established a relationship before the injury.

Certified managed care plan case managers, who are licensed health care professionals, monitor and coordinate the delivery of quality medical treatment, help the parties communicate with each other and the doctor, and promote an appropriate, prompt return to work. The certified managed care plan must also include a process for resolving disputes.

2. How do I know if I am covered by a certified managed care plan?

3. What is the process for resolving disputes under a certified managed care plan?

4. Can I get a list of certified plans?

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If you don't see your question answered here or want more information about certified managed care, contact the Minnesota Department of Labor and Industry at (651) 284-5005, toll-free at 1-800-342-5354 or TTY at (651) 297-4198.