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Reporting/Compliance

EDI

OMCA is a trading partner with the Kentucky Department of Workers Claims for IA-1 and all subsequent reports.

Custom Reporting

Case management reports can be modified to meet the needs of the individual client. Case management notes can be electronically transmitted into the adjuster electronic claim file, faxed or e-mailed per the client's request.

Injured Worker

OMCA staff works with the injured worker to obtain prompt, effective medical care for treatment of the work injury. The Nurse Case Manager is a resource for the worker to obtain information regarding their injury, prescribed medications and proposed treatment. The Nurse Case Manager helps the worker successfully navigate the medical system to return to their pre-injury state of health.

Employer

The OMCA system assists the employer in reporting claims promptly, obtaining information regarding the work status of injured worker and identifying work duties that could allow the employee to return to work within medical restrictions. Those employers who enroll in the OMCA managed care system are assisted in selecting the network of medical providers from which the employee may choose, thereby reducing the opportunity for malingering by those few workers who may attempt to work the system.

Provider

OMCA works closely with the medical provider to get the employee the appropriate care at the appropriate level without delay. Unless there is an issue with compensability of the claim or relatedness of the procedure most pre-certs are approved with the initial phone call. Providers within the OMCA network have access to a provider relations representative who can assist them with questions related to claims filing and reimbursement questions.