(A) Upon review by and satisfactory to the bureau that the provider has met bureau credentialing requirements, the bureau shall mail a provider agreement to the provider.
(B) The provider agreement shall include at a minimum the
following provisions, as more fully detailed within the provider agreement itself. The
provider agrees to:
(1) Provide health services that are applicable to a work-related injury, and not
to substantially engage in the practice of experimental modalities of treatment.
(2) Provide adequate on-call coverage for patients.
(3) Utilize bureau-certified providers when making referrals to other providers.
(4) Timely schedule and treat injured workers to facilitate a safe and prompt
return to work.
(5) Release information from the national practitioner data bank or the federation
of state licensing boards. The bureau may submit a report to the appropriate state
licensing board or the data bank in the event that the provider agreement is terminated
for reasons pertaining to the provider's professional conduct or competence.
(6) Practice in a managed-care environment and adhere to MCO and bureau
administrative procedures, and procedures concerning provider profiling data, peer review,
quality assurance, utilization review, billing procedures and dispute resolution, subject
to rule 4123-6-16 of the Administrative Code.
(7) Pursuant to procedures developed by the bureau and the MCOs, report injuries of
employees to employers and the bureau.
(C) Upon completion, signing and return of the provider agreement and approval of the bureau, the provider is a bureau-certified provider enrolled in the HPP and eligible for inclusion on the provider panel of an MCO as an MCO panel provider.
(D) By signing the provider agreement, the provider agrees to abide by all bureau HPP and medical rules.
Effective date: Feb. 16, 1996