How do I report a new Workers Compensation claim?
On-line at ClaimZone Reporter. The supervisor is able to complete the first report via the web-site. User ID and password required for access.
By phone at 888 606-2562. The phone will be automatically answered "Montgomery County Self-Insurance Program, first report of injury". A telephonic first report representative will receive your call and prompt you through the questions necessary to complete the report. The representative will complete the First Report of Injury (FROI) report, electronically forward a copy to the MCSIP claim office and return a copy to the reporting individual, if requested.
How do I obtain an ID and password to ClaimZone Reporter?
Please contact Pearl Monroe at PMonroe@mcinnovations.com.
How do I report a new Liability and Property claim?
There are four methods to report a claim: Email, Fax, Telephonic, and Internet. Please follow the instructions as noted under Report a Liability Claim and Report a Property Claim.Does the employee need approval for the initial treatment?
No, the initial medical treatment does not require adjuster approval.
How do I help the injured employee locate a physician?
Physicians with various specialties can be located by accessing the OneNet PPO Network. In addition a nurse case manager dedicated to the program can be reached at (301) 944-6280 Monday- Friday 8:00 AM to 5:00 PM to assist with locating a physician.
If the employee needs to fill a prescription, what do I tell them?
First Script provides a large network of area pharmacist with many locations open 24-hours. Immediately following the accident the supervisor can print a temporary Pharmacy Card which allows the employee to obtain medication related to the injury without any direct cost. Select the Pharmacy Tab and fill in the pertinent information, print and provide to the employee.
Locating the nearest pharmacist is easy and only requires the employee's zip code. Select the Find a Pharmacy tab and enter the zip. A second option is to call First Script at 800-791-2080 to speak directly with a customer service representative. A representative is available 24/7.
Where should the employee send medical bills for payment consideration?
All medical bills should be submitted to:
Gallagher Bassett Services Inc.
Post Office Box 23812
Tucson, AZ 85734
The employee has a disability slip from the doctor, what should I do with it?
A copy of the slip should be faxed to the adjuster. If the physician indicates the injured worker can return to work with or without restrictions, the adjuster must be notified.
Should I notify the adjuster when the employee returns to work?
Yes, please notify the adjuster once the employee returns to work .
The employee has a question about workers compensation benefits, who should they call?
The employee should be instructed to contact the adjuster directly. Please see the directory for a listing of all adjusters and their contact information.
A citizen has filed a liability claim but has questions, who should they contact?
The citizen should be directed to the Gallagher Bassett Services, Inc claims office. The liability supervisor can be reached at (301) 944-6256.