Managed Care Services

Management of the medical expense portion of a claim is critical. Medical claim costs can escalate quickly, so Intact Insurance works with key partners to deploy a full array of cost containment programs. These programs begin immediately after an injury occurs and will continue as long as treatment is medically necessary. Our cost containment programs include:

Preferred provider organizations:

Genex Provider Pathways is utilized for all States, however for the California MPN please note specific instructions below.

Accessing the Genex Provider Pathways Channeling Site:
- Go to: www.genexservices.com.
- Click Find a Provider/Genex Provider Pathway (top right)
- Login with Username: WCC and Password: Claims
Features:
- Search for Network Providers by address, name and region
- Create Work Site Posters

If you have any problems accessing Genex Provider Pathway, Contact GenexProviderPathway@genexservices.com or download the user guide.

California MPN

Genex Provider Pathways may be used to access the Genex MPN #2500. Or you may request a regional list of all MPN providers in your area by calling the MPN Contact noted below.

Employer Access to the Genex Provider Pathways Channeling Site:

Go to: www.genexservices.com.
Click Find a Provider/Genex Provider Pathway (top right)
Login with Username: WCC and Password: Claims
Select the CA MPN ID# 2500 Network
Features:
- Search for Network Providers by address, name and region
- Create Work Site Posters

Employees or their Representative Access to the Genex Provider Pathways Channeling Site:

Go to: www.genexservices.com.
Click Find a Provider/Genex Provider Pathway (top right)
Login with Username: Genex3 and Password: CAMPN3

In order to obtain all of your Genex MPN #2500 documents and other claim related information, please visit the State-Specific Forms & Resources page and filter to California.

For more information you may contact the MPN Contact or Medical Access Assistant for the Genex MPN #2500:

MPN Contact:

Name: Genex Services
Title: CAMPN
Address: 88 South Disneyland Dr., Suite 300, Anaheim, CA 92802
Phone: 800-822-6099 (Press 8)
Email: genexmpnservices@genexservices.com

Medical Access Assistant:

Phone: 866.266-8702
Fax: 800-560-8247
Fax number: 866.266-8702
Email address: MPNMAA@genexservices.com

Coventry Workers Compensation Health Care Network (HCN): Access to the Coventry Workers Compensation HCN Employee Instructions and other supporting HCN documentation can be found in our resources section.

Pharmacy First Fill Program - Optum

First Fill Program – A prescription drug card program designed to ensure that the injured worker receives their initial medication as soon as possible after sustaining an injury, even before the claim is accepted as compensable. This program provides access to our national network of over 60,000 pharmacies with NO out-of-pocket costs for the injured worker. There is an $85 cost limit and a 10 day supply limit and the temporary card expires 30 days after the injury.
Once a claim is accepted as compensable, generally within 7-14 days, a personalized prescription card will be mailed directly to eligible claimants allowing full refills of covered prescriptions.
Our Pharmacy Benefit Manager (PBM) will absorb the cost of the first fill prescription if the claim is later denied or the medications are unrelated to the injury. OneBeacon covers the costs of the first fill prescriptions for injury related medications that are medically necessary on claims that are ultimately accepted as compensable.
- For All States our Pharmacy Benefit Manager (PBM) is TMESYS, a nationwide pharmacy network for Optum. To locate participating pharmacies, please visit https://workcompauto.optum.com/pharmacylocator
- To locate a First Fill card, search for State-Specific Forms & Resources.
- New York has specific requirements. To locate a NY First Fill Card, select NY in State-Specific Forms & Resources

Intact Insurance Specialty Solutions is the marketing brand for the insurance company subsidiaries of Intact Insurance Group USA LLC. Coverages may be underwritten by one of the following insurance companies: Atlantic Specialty Insurance Company, a New York insurer; Homeland Insurance Company of New York, a New York insurer; Homeland Insurance Company of Delaware, a Delaware insurer; OBI America Insurance Company, a Pennsylvania insurer; OBI National Insurance Company, a Pennsylvania insurer; or The Guarantee Company of North America USA, a Michigan insurer. Each of these insurers maintains its principal place of business at 605 Highway 169 N, Plymouth, MN 55441, except The Guarantee Company of North America USA, which is located at One Towne Square, Southfield, MI 48076. This material is intended as a general description of certain types of insurance coverages and services. Coverages and availability vary by state; exclusions and deductibles may apply. Please refer to your insurance policy or consult with your independent insurance advisor for information about coverages, terms and conditions. Some coverage may be written by a surplus lines insurer through a licensed surplus lines broker. Surplus lines insurers do not generally participate in state guaranty funds and insureds are therefore not protected by such funds.