Network Information

Coventry's Workers' Comp Networks

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Certified PPO

A Certified PPO is a plan certified by the Department of Health, owned, operated or administered by an entity that has the capacity to establish a network of service providers and that provides or arranges for the coordination and delivery of all required services.

Benefits of a Certified PPO model include:

• Direction of Care for 30 days from the first visit with a PPO provider
• Discounted fee arrangements with PPO Participating Providers
• Mandatory care management including
• Utilization Review
• Return to Work
• Telephonic (TCM) and Field Case Management (FCM)

Certified PPO Highlights

Learn more about MetraComp's certified PPO

Recommendation of Care

A Recommendation of Care model is defined as actively endorsing or promoting the use of a designated network or health care provider(s) for the treatment of an injured employee.
 
Benefits of a Recommendation of Care model include:

• Carrier/employer may recommend network to all injured workers
• PPO discounts available on all claims where ROC rules have been followed
• ROC program may be used in non-certified counties
• Existence of carrier/network contract is considered recommendation of care even if not actively recommending

Recommendation of Care Highlights

Learn more about MetraComp's Recommendation of Care model

New York Provider Update

Click here for the latest New York provider update.