FEEDBACK FORM

We encourage you to take a few moments to give us your feedback, whether good or bad. Feedback is critical to us as it helps us identify areas the providers and their staff need improvement. 

Should you require any immediate assistance, work notes, work statuses, follow-up appointments, or if you need assistance with DWC-25, etc. or work prefer to respond by telephone; please feel free to contact us at

1-866-640-4060. 

Other methods of feedback:
Confidential compliance hotline is always available at

1-866-640-4060

 

Please add any questions, comments, concerns, and/or suggestions you may wish to share with us.

Are your claimants/employee's seen timely?
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During each visit are the physicians completing the DWC-25 properly? Including:
  • diagnosis
  • treatment plan
  • noting and identifying specific restrictions, if any, and why the Injured Employee cannot return to work full duty
  • the causal relationship to the injury the date and time of the next appointment, if applicable
  • The Physician gives a completed copy of the DWC-25 to the Injured Employee
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Are the Physician following protocols when writing a prescription for radiology, therapy, DME, orthotics, other services, etc.?
All/any restrictions must be very clearly specified on the DWC-25 relating 
to the Injured Employee’s ability to return to work either full or modified duty and why the restrictions are necessary:
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Does the provider understand the employers hold the responsibility of making accommodations for Injured Employees who are determined to have work restrictions based on the Physician’s documentation on the DWC-25?
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Our providers MUST understand this is a team effort with the adjuster, employer, nurse case manager, telephonic case manager, and the Physician along with each Injured Employee?
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Are authorized services being over utilized?
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Are the physician notes written at each appointment consistent with the information contained in each DWC-25?
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The following are NOT acceptable under any circumstance regarding restrictions on the DWC-25 form:
  • “Work as tolerated” 
  • “Same as before”
  • “No Change” 
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The goal is to provide prompt, timely, efficient and superior medical care to each Injured Employee and assist each Injured Employee during injury recovery:
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If you would like us to contact you, please fill out your contact information below (you may leave it blank to stay anonymous):
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GET CONNECTED
305.323.1238
WCTEAM1@OMMKTG.COM
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