Thank you for considering participation in EK Health Services Workers’ Compensation Provider Network! The following are answers to some questions you might have.
Q. Who is EK Health Services?
EK Health Services, founded in 1998, is based in San Jose, CA. The company offers a complete line of Workers' Compensation healthcare management services including medical provider networks, medical case management, utilization review, and peer review. In addition, the company offers bill review, ergonomic evaluation and training, occupational health services, life care planning, and interpretation services.
Q. Why did I receive this application?
EK Health Services is expanding its services to develop Workers’ Compensation medical provider networks for employers. On January 3, 2011, EK Health Services began recruiting quality medical providers with Workers’ Compensation experience throughout the state of California. EK Health is developing Workers’ Compensation medical provider networks as a result of increasing client demand for customized Medical Provider Networks (MPNs). The company plans to rapidly build a broad network of quality and Workers’ Compensation experienced providers in California so employers can have quality MPNs.
Q. Where did you get my information for your mailing list?
EK Health Services develops its proprietary mailing lists form various public sources and referrals.
Q. Why should I participate in EK Health’s Workers’ Compensation Provider Network?
You should want to partner with a company that is growing and can add value to you through increased revenues and referrals. EK Health Services grew its annual revenue by 11% in 2010. We have prospective client demand for us to develop MPNs, which is why we are inviting you to participate.
In addition, unlike some companies who will pay you a discount off the California Official Medical Fee Schedule (OMFS), our clients will not discount their payments if ACOEM, MTUS and or other EBM guidelines are followed.
Q. Where can I find the California Official Medical Fee Schedule?
The Official Medical Fee Schedule (OMFS) is promulgated by the DWC administrative director under Labor Code section 5307.1 and can be found in sections 9789.10 et seq. of Title 8, California Code of Regulations. It is used for payment of medical services required to treat work related injuries and illnesses. For additional information about the OMFS, visit the California Department of Industrial Relations website at http://www.dir.ca.gov/DWC/OMFS9904.htm.
Q. Will EK Health Services pay my claims?
No. EK Health Services is not a Payor nor does EK Health Services guarantee payment. Workers’ Compensation claims are paid by the employer’s worker’s compensation carrier or the employer, if it is self-insured.
Q. What other providers participate in EK Health Services Workers’ Compensation Provider Networks?
Due to client demand, EK Health Services is currently recruiting quality providers with solid Workers’ Compensation experience for their participation in EK Health’s Workers' compensation Provider network. In addition, EK Health is partnered with Kaiser Permanente’s Workers’ Compensation Network. This network, called Kaiser On-The-Job, is dedicated to providing employees with healthcare for work related injuries and illness. Kaiser On-The-Job currently has over 2,400 providers throughout California.
Q. If I decide to participate, what would be my effective date?
Acceptance is contingent upon meeting our credentialing criteria and evaluating provider access needs. If you are accepted, your effective date will be the date that EK Health executes your Agreement on page 3 of the signed contract you submitted to EK Health Services.
Q. How long will it take before I know I am accepted?
In general, it will take 90 days from the time you submit your signed contracts, California Participating Provider Application (CPPA) and required documents listed in the cover letter that was included in your contract package. This timeframe is required to seek missing information; verify numerous credentialing criteria; execute your Agreement; and load your demographic data into our systems for provider directory and patient channeling purposes.
If you are accepted, you will receive an acceptance letter, a copy of your executed Agreement.
Q. For which employers has EK Health Services developed MPNs?
We are currently developing Medical Provider Networks (MPN) for employers in California.
Q. When will I receive referrals and how many referrals will I receive?
EK Health Services started its initial recruitment in January, 2011. We plan to develop Medical Provider Networks (MPN) for employers in California sometime later this year. When that happens, injured workers would access the MPN, and you could potentially receive referrals depending on the employer and injured workers’ locality. We anticipate referrals would come in late 2011 or early 2012. The number of referrals is based on where you practice, where the MPNs are located and the medical needs of injured workers.
Q. Who should I contact if I experience claim payment issues?
Because EK Health Services is not a Payor, you should first contact the Payor of the injured worker, whether it is an insurance company or the employer. Contact information is typically provided on the injured workers’ health benefits identification card. If after contacting the Payor your payment issue is not resolved, you may contact EK Health Services at (877) 861-1595, Ext. 158 to assist in coordinating resolution.
Q. Who should I call if I have additional questions relating to a contract with EK Health Services?
You may refer to the EK Health Services Workers’ Compensation Provider Handbook that will be delivered to you upon network participation acceptance. In addition, you may contact EK Health Services at (877) 861-1595, Ext 158.