Channeling Tools Medical Provider Network

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Channeling Tools Medical Provider Network
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Review of Employer Responsibilities Under the MPN

• Responsibilities at time of MPN implementation
  and/or MPN change
• At time of hire or transfer of employee to
  California
• At time of injury
• Selection of Initial Treating Provider for each
  employer location Channeling Tools and Worksite
  Posters

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Review of Employer Responsibilities Under the MPN
at the Time of Implementation
An Employee Notification Letter is provided to
all current California employees in both English
and Spanish. This letter is provided 30 days
prior to the MPN implementation.
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Employer Responsibilities at Time of Hire or
Transfer of Employee to California

• Employee Notification Letter and Acknowledgement
  Form provided in new hire/transfer
  materials.
• Place signed employee MPN acknowledgement in
  employee file.
• If the employee provides a provider
  pre-designation, also place this form in the
  employees HR file.
• Review procedures with the new hire that they are
  to follow in case of work related injury.
• Show new hire where worksite posters are located
  and point out provider info on posters.

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Review of Employer Responsibilities Under the MPN
at Time of Injury

• The employer is required to arrange the initial
  medical evaluation at time of injury.
• The employer will provide the employee with the
  same Notification Letter and Acknowledgment Form
  that is provided at hire or with rollout. Place
  singed ee MPN Acknowledgement Form in employee
  file and provide a copy to the Adjuster.
• In an emergency, direct the injured worker to the
  nearest hospital or call 911.

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Review of Employer Responsibilities Under the MPN
at Time of Injury

• For non-life threatening injuries, direct the
  employee to the participating MPN provider listed
  on the worksite poster for that employer
  location.
• On the same day that the employee reports injury
  requiring medical care, call the provider listed
  on the work site poster to confirm an appointment
  for the employee. If you cannot get an
  appointment scheduled within 2 days, immediately
  contact the Adjuster for assistance.
• Complete all required paperwork for the PEO,
  Cedar Hill and the Adjuster.
• Fax a copy of the employees MPN Acknowledgement
  Form to the Adjuster

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Review of Employer Responsibilities Under the MPN
at Time of Injury

• If the employee has provided a valid
  pre-designation form prior to the date of injury,
  the employee has the right to seek treatment
  through his/her pre-designated physician. The
  employee should arrange for an appointment within
  2 days of their first report of injury. You must
  provide a copy of the written pre-designation
  notification to the Adjuster. The Adjuster will
  verify the validity of the pre-designation.
• The MPN Contact Info is contained in the
  Notification Letter. Point this info out to
  the injured worker.

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Channeling Tools
GENEX Provider Pathway

• The GENEX Provider Pathway is an Internet-based
  network referral system designed to help you
  quickly and accurately locate providers/clinics
  in the MPN in order to refer a claimant to the
  closest and most appropriate network member (e.g.
  medical specialist).

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When do I use the Provider Pathway?

• To develop worksite posters for your clients
  prior to injury occurrence.
• Each time there is an injury, you and the
  adjuster have the opportunity to direct the
  claimant to a provider or facility within the MPN
  for initial care and ongoing care.

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GENEX Provider Pathway Access

• Enter www.genexservices.com into the address bar
  of your browser such as Netscape or Internet
  Explorer.
• Select Customer Resources found in the blue
  horizontal band.
• Select GENEX Provider Pathway from the list.
• Once the log in screen appears, enter the
  applicable user id and password User id GNX,
  Password gnxi11
• Select Address Search
• On the right side of the screen, select First
  Health MPN Select
• Enter the Employer Name and street address in the
  window on the left side of the screen.
• Choices Sort by distance, provider name or
  specialty. Distance is the default. 5 mile
  radius from address.
• Choices Select refine search or
  Click one
  or more provider types and then select find
  providers

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GENEX Provider Pathway Access

• Refine Search
• A list of provider types will appear
• The number of providers for a particular
  specialty will follow in parentheses
• Select all provider types that you wish to search
  
• A list of all providers within the specialties
  select will appear
• Click the providers or providers that you wish to
  use
• Choose to Create Wallcard, Excel Spreadsheet,
  Directory, or Map and Driving Directions
  to the Provider
• Find Providers
• A list of providers will appear
• The number of providers for a particular
  specialty will follow in parentheses
• Select all provider types that you wish to search
  
• A list of all providers within the specialties
  select will appear
• Click the providers or providers that you wish to
  use
• Choose to Create Wallcard, Excel Spreadsheet,
  Directory, or Map and Driving Directions
  to the Provider

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Thank You For Your Partnership