![]() the appropriate MPN doctor is not available within a reasonable distance from the injured workerĪfter the first medical visit following an injury, the injured worker can select any doctor within the medical provider network.the employer or insurance company does not provide the injured worker MPN information.Injured workers will generally have to be treated by a doctor within the workers’ compensation medical provider network. If an injured worker is not satisfied with the treatment program of the treating physician, he or she can request a second opinion from another doctor. If the injured worker disagrees with the second opinion doctor, he or she can request a third opinion. If the injured worker disagrees with the third opinion, he or she can request an Independent Medical Review. Treating with doctors removed from the MPN In this article, our California personal injury attorneys will explain: If any doctor disagrees with the opinion of the current treating physician, the injured worker can change treating doctors. Medical Provider Networks are a group of doctors approved by a workers’ compensation insurance company to provide treatment to injured employees. Medical treatment is a required benefit for injured workers in California workers’ compensation. 1 However, an injured worker cannot be treated by just any doctor. If an insurer or employer establishes a Medical Provider Network (MPN), an injured worker must be treated by a doctor within the network. 2Įach employer can establish their own MPN, but the network must give injured workers access to medical treatment. chiropractic practitioners licensed by California state law.physicians and surgeons holding an M.D.The network must have enough doctors to treat common work injuries in all geographic areas of California where an injured worker may live. ![]() 4Įach MPN is required to have a list of doctors available online. 5 The online list gives injured workers the ability to schedule appointments without waiting for the insurance company to provide the information, which could cause significant delays. The Department of Workers’ Compensation provides a list of current MPNs that are active in the state.Įxample: Andrea injures her back at work. ![]() She is sent to an urgent care clinic by her employer. Andrea is not very happy with the treatment she receives at the industrial clinic.īefore she goes back to the industrial clinic, Andrea receives a letter from the insurance company that has the web address of the employer’s MPN. She goes online and finds a different doctor to be her treating physician. Andrea cancels her clinic visit and calls to schedules her first visit with her new treating doctor. The insurance company must accept Andrea’s selection because the doctor is in the MPN. MPN doctor and treatment guidelinesĪll treatment in workers’ compensation is based on medical treatment guidelines that determine “the frequency, duration, intensity, and appropriateness of all treatment procedures and modalities commonly performed in workers compensation cases.” 6 This is for the purpose of ensuring that injured workers receive a standardized level of care.Īll MPN doctors must follow the medical treatment guidelines through a process is called Utilization Review (UR). 7 Medical treatment requests are sent to an independent physician that can approve, modify, or deny the treatment request. The MPN and Utilization Review work together to direct an injured worker’s medical treatment. #MEDICA IN INETWORK PROVIDERS PASSWORD#.Please contact the customer service department on the back of your member identification card to confirm that you have in-network access to Mayo Clinic. ![]() Mayo Clinic may not be at the highest benefit level or participate in every product offering from the health plans listed below. Your benefit coverage for care provided by Mayo Clinic is determined solely by your insurance company and is based on the provisions of your specific medical benefit plan. ![]() This list is not meant to be all-inclusive please check with your health plan to verify coverage. This information is updated periodically and is subject to change. Mayo Clinic providers and hospitals are contracted with the organizations listed in the documents below. ![]()
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