Intracorp Workers’ Comp HCN Certified by Texas Department of Insurance
Philadelphia, Pa.-based Intracorp announced that the Texas Department of Insurance has certified it as a workers’ compensation health care network (WCHCN). So far, the department has approved nine networks, including Intracorp’s, under Texas House Bill 7, which enacted workers’ compensation reforms, including the creation of WCHCNs, to control escalating workers’ compensation costs and improve mediocre return-to-work results.
“We are very pleased to have received our certification and to begin offering Texas employers, TPAs and carriers an additional resource for managing their workers’ compensation costs and for returning employees to productive work,” says Archie Anderson, president, Intracorp Disability Management.
“However, customers should recognize that contracted network providers alone won’t solve the problem of skyrocketing costs and prolonged durations,” says Anderson. “For that to happen, employers need a comprehensive disability management solution that includes aggressive case management, network-defined utilization review, treatment and return-to-work guidelines, a strong return-to-work focus and fee management, services that Intracorp has proudly offered as an industry leader for more than 35 years.”
Texas WCHCNs are similar to workers’ compensation certified managed care organizations (MCO), which have been created in a number of states. In Texas and other MCO states, there are additional requirements, such as mandatory medical management and adherence to treatment and duration guidelines, that would not be required under a typical preferred provider agreement.
Certified self insured employers and carriers are not required by law to participate in a WCHCN, but if they do, any employee who is injured on the job and lives within the service area must choose a treating doctor who is in the WCHCN. Exceptions to this rule include emergency care and/or when the employee designates that an HMO primary care provider be his or her treating doctor for a workers’ compensation injury. Designated HMO primary care providers who treat an injured worker must adhere to the WCHCN’s case management process and utilization guidelines.
“As we’ve seen throughout the country, there can be a meaningful improvement in overall costs and return-to-work outcomes in states that have implemented managed care networks,” says Anderson. “We are pleased to be at the forefront of this major change in Texas and to being in a position to offer employers a meaningful and complete disability management solution.”
Intracorp is a subsidiary of CIGNA Corporation.
Source: Intracorp