Injury Reporting Packet

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1 Injury Reporting Packet University of Cincinnati

2 IMPORTANT NOTICE FOR WORKPLACE INJURIES In the event of a work-related injury when University Health Services is open, please see one of the medical providers recommended by your employer listed below and follow these important steps: Report the accident immediately to your Supervisor. Select a medical provider from the following list for immediate care.* For additional providers, call CareWorks from 8:00 a.m. 5:00 p.m. at In the event of a life threatening injury or when University Health Services is closed, seek the closest hospital emergency room regardless of physician network affiliation or BWC certification status. PROVIDER LISTINGS FOR WORKERS COMPENSATION HEALTHCARE PROVIDERS University Health Services University of Cincinnati Academic Health Center Holmes Building, 4th Floor (513) Hours: 8:00 a.m. - 4:00 p.m., Monday, Tuesday, Thursday, & Friday. 9:30 am 4:00 pm, Wednesday University of Cincinnati Contact Human Resources Service (513) *Employees may receive treatment from any BWC certified provider.

3 Workplace Injury. Take the Right Steps. Helping Simplify the First Report of Injury (FROI) Process INJURED EMPLOYEE 4-STEP PROCESS Immediately notify your employer. Complete the first two sections of the BWC First Report of Injury form as completely as possible. This Injury Reporting Packet contains a CareWorks I.D. card. Show this card to every medical provider that treats your work-related injury. Then, seek treatment from a CareWorks*networkprovider. 1 2 EMPLOYER 2-STEP PROCESS Complete the Employer Info. section of the BWC First Report of Injury form. Fax completed form to CareWorks, toll-free, at Call CareWorks to report the injury, toll-free, at Or, report your injury over the Internet by visiting CareWorks Internet Injury Reporting Center at In emergency cases, injured workers should immediately notify their employer and seek treatment at the nearest medical facility. *According to Health Partnership Program (HPP) guidelines, injured workers may seek treatment from any BWC-Certified medical provider

4 University of Cincinnati P.O. Box Cincinnati, Ohio

5 University of Cincinnati CareWorks University Health Services

6 Your employer has selected CareWorks to medically manage its workers compensation medical benefits. If injured at work, please follow these important steps: 1. Immediately notify your employer and complete the BWC First Report of Injury (FROI) form and fax to CareWorks as quickly as possible, toll-free, at If unable to notify your employer, please call CareWorks, toll-free, at to report your injury. 3. Show this card to each and every medical provider that treats your workplace injury. WORKERS COMPENSATION MCO IDENTIFICATION CARD

7 FOR WORKERS COMPENSATION INJURY MANAGEMENT ONLY University of Cincinnati BWC Policy # Contact Human Resources Service (513) Attention Provider You are required by Rule to report work-related injuries within 24 hours. Attention Employee This card is for information purposes only. This card is not a guarantee of coverage. Send Medical Bills to: CareWorks P.O. Box Columbus, Ohio Customer Service: Injury Reporting Fax: Prior Authorization Fax: Internet: For prescription drug information, contact OHIOBWC or visit

8 KEY INFORMATION Medical Management Information Medical Bill Payment Information Other Important Information FAX medical information to: (toll-free) MAIL medical information to: CareWorks P.O. Box Columbus, Ohio Prior Authorization Fax C9 form to (toll-free) Mail medical bills to: CareWorks P.O. Box Columbus, Ohio Billing Questions Call CareWorks Customer Service, toll-free, at Prescriptions For questions regarding prescriptions, please contact BWC at OHIOBWC or visit Provider Search and Injury Reporting Visit for online injury reporting and provider searches Glendon Court Dublin, Ohio Lombardo Center, Suite 515 Cleveland, Ohio

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