One of the most important elements of Claims Management is timeliness. The sooner you report an incident to us, the better. When an incident is reported immediately, it makes it much easier for us to handle it effectively. We can then assign case management, investigation or any other intervention that would appropriate. This also allows us to initiate diagnostic studies to evaluate need for further treatment and expedite the claimant’s return work. Click here to see a sample C-2F, which should be completed by the injured worker’s supervisor and submitted to Triad ASAP. In compliance with Workers Compensation Board requirements, an injured worker will be given a claimant information packet which will provide them with paperwork to be completed. This packet will also inform them which Provider Networks should be used for diagnostic testing and prescription medication.
The Workers Compensation Board will require Forms that detail the claimant’s payroll information and time lost from work. These forms are completed by the Employer, and submitted to Triad. They are Forms C-11, C-240, C-107. A C-11 and C-2F is the employer’s report that the claimant is losing time as a result of the injury. A C-240 shows the payroll of the claimant for one year prior to the date of injury. A C-107 is a request for reimbursement for wages paid. Sometimes the Board will request updated Forms even though the information has not changed. This can be a tedious process. However, failure to comply could result in penalty, so it is important that these Forms are completed and submitted upon request.
Once your injury has been reported to us, you will be assigned a Carrier Case Number (Claim Number). Give this number to your medical provider so that they can bill us properly. You will receive a prescription card from our vendor PMSI/Tmesys for any medications you may need as a result of your injury. This card is accepted at most pharmacies for your convenience. The more information we have, the better able we are to ensure that you receive the care you need.
If you require diagnostic testing such as an MRI, EMG, etc., you can set up your exam through our network, One Call Care Management.
If you have any questions during this process, please feel free to call us at (800) 337-7419. Check for Frequently Asked Questions from the Worker’s Compensation Board’s Web Site.
If you would like a friend or family member to be able to communicate with us concerning your claim, please execute this form and forward to us via fax or e-mail.
If you are an attorney or representative and are interested in partnering with us, please contact us.
When calling for status of a medical bill, please have as much information as possible (Claim Number, Patient Name, Patient Employer, Date of Injury, etc.). This will allow us to assist you quickly and efficiently. Medical bills are paid within 45 days of receipt. Please make sure that we have an updated W-9 Form with your Tax ID Number and mailing address for payments. We cannot issue payment without an up-to-date W-9 that matches your bill. If you have any questions, please call us at (800) 337-7419. We pay per the applicable Medical Fee Schedule. For more information, click here.