Calif. Backs Sedgwick CMS Medical Provider Networks

March 17, 2005

Sedgwick Claims Management Services Inc. (Sedgwick CMS) announced that the Administrative Director of the California Division of Workers’ Compensation (DWC) has approved 20 filings of medical provider networks (MPNs) based on the Sedgwick CMS panel of California medical providers. Action is pending on additional filings. The MPNs will provide medical services to workers’ compensation claimants employed by Sedgwick CMS clients.

A successful MPN filing is critical for employers seeking better control of workers’ comp costs through full implementation of SB899, California’s workers’ comp reform legislation. Networks must meet requirements for mix of physician specialties, convenience of access to care, provider compliance with DWC medical treatment guidelines, and availability of choices of providers for treatment and for second and third opinions.

The Sedgwick CMS California MPN program reportedly offers client employers two principal advantages:

Physicians and other medical service providers are selected for the panel based not only on credentials but also on demonstrated superior results in the treatment of occupational injury patients. Providers are screened based on medical outcomes, economic impacts such as successful returns to work and average paid per claim, and other results-oriented criteria.

Sedgwick CMS reportedly makes participation more convenient for clients by offering training webinars; an application package and other support in preparing filings for the DWC; extranet access to instructions, forms and approved employee communications; and a fulltime MPN coordinator for assistance with questions about implementation and ongoing network operation.

Was this article valuable?

Here are more articles you may enjoy.