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NYSIF announces Recommendation of Care Program

Voluntary program could save businesses as much as 15% on the cost of claims

The New York State Insurance Fund (NYSIF) has launched a program designed to decrease the cost of workers’ compensation insurance claims. The Recommendation of Care (ROC) program utilizes a medical provider network for the treatment of workers’ compensation claimant injuries.

“Medical fees are a primary cost driver in escalating workers’ compensation costs,” said Francine James, NYSIF chief deputy executive director. “We’re pleased and optimistic about making this program available to our policyholders who want to begin to drive down medical claims costs, and we are expecting great results.”

NYSIF is providing the ROC program through the MetraComp medical provider network. MetraComp is a solely owned subsidiary of Coventry Workers’ Comp Services, whose focus is to reduce workers’ compensation costs with potential savings of as much as 15 percent on the medical cost of claims.

NYSIF policyholders, such as those in the Retail Council’s Safety Group 493, must sign a ROC Acknowledgement Form available at www.nysif.com to participate in the voluntary program, and e-mail a signed copy of the form to Roc@nysif.com or send it to NYSIF’s Claims Administration unit at 199 Church Street, New York, NY 10007.

Ms. James reminded policyholders who participate in the program that they must still follow standard protocol by giving injured workers the Claimant Information Packet as required by New York State at the time of injury. Employers can download the packet at NYSIF’s website.

Additionally, policyholders must give the injured worker Form C-3.1, “Notice of Right to Select a Workers’ Compensation Board Authorized Health Care Provider,” immediately upon learning of the injury. Form C-3.1 also can be downloaded through the website.

If sent by mail, send Form C-3.1 by certified mail with return receipt requested. The policyholder must document all attempts to have the injured worker sign and return the form to the policyholder. However, receipt or non-receipt of the signed C-3.1 cannot hinder any injured employee in securing timely, appropriate treatment for a work-related injury or illness.

NYSIF stresses use of the MetraComp network of medical providers is strictly voluntary on the part of the employee. Whether or not a policyholder signs up for the ROC program, the injured worker retains the right to select any physician, podiatrist, chiropractor or psychologist authorized by the New York State Workers’ Compensation Board to perform treatment.

“The choice of a treating doctor always rests with the claimant,” Ms. James said. “We hope the ROC program is a useful tool for both the claimant and the policyholder in the selection process.”

Injured workers can obtain a list of authorized healthcare providers from the Workers’ Compensation Board. NYSIF policyholders can visit the ROC page at www.nysif.com for more information and instructions on participating in the ROC program, or call the Retail Council’s Insurance Services Department at (800) 442-3589 for assistance.