MCO Solutions

MCO Solutions is a Marxware developed package for use by Ohio Bureau of Workers' Compensation (BWC) certified Managed Care Organizations (MCO).

The MCO is the primary contact between the Employer, Injured Worker and the treating Providers. The MCO Solutions application stores all BWC required information about the injury, treatment plan, correspondence, provider bills and payments. MCO Solutions stores this information for each claim in a Microsoft SQL database. Much of the collected information is transmitted to BWC via EDI transaction sets as the information is changed.

MCO Solutions consists of over 150 different forms, some of which are parameter maintenance forms. The application requires a login so that only pertinent menu items and forms are displayed. Based on the user security level, each form may be denied, shown as inquiry only or allow full maintenance. Behind the scenes there is an audit trail showing the times each user logged into the system, and down to the field level, which fields they changed showing the before and after values.

When an employee gets injured on the job, the MCO files or makes sure a First Report of Injury (FROI) is filed explaining the circumstances surrounding the injury and describing the injury itself. The form below is a sample showing the FROI entry form.

Notice in the form to the left that we utilize a tabbed form allowing many pages of information to be viewed or maintained. Unless you are an MCO or have been exposed to BWC procedures the information being displayed is not important. The point being made is the capabilities we have built into the forms, allowing a search by SSN and pull down control for items with finite values like gender or marital status.

When developing a custom solution, workflow and ease of use have to be the highest priority. If the tool is hard to use or train, the final outcome will not be accurate or complete. When an application is created, all forms act the same. Once you know how to use any form, you already know how to use the remaining forms. Once you learn how to search and choose an injured worker in this case, the same method would be used to search and select a provider for instance. By having this consistency, training is much easier and allows the training to concentrate on why and where information is stored instead of on how to use the tool.