RediMD.ConcentraOptumRXAlliance

When Member employees are injured on the job, we’re there every step of the way to help them get the care they need.

Superb quality and cost-effective medical care

The Fund belongs to a medical provider network with four other risk pools. The Political Subdivision Workers’ Compensation Alliance helps employees receive timely medical care from qualified health care providers.

The Alliance helps employees return to work 72 percent quicker after injury and medical costs 24 percent less per claim, compared to non-network.

The Fund saves costs on medications and reduces the unnecessary use of opioids with pharmacy benefits from OptumRX.

Telemedicine

Injured employees can receive medical care without traveling at no extra cost. Fund members can set up telemedicine for Workers' Compensation with Concentra or RediMD.

Expert claims service

When member employees suffer an injury at work, dedicated case managers help get them to a medical professional quickly. They become an integral part of the recovery process by staying in touch with the injured employee and a team of medical professionals.

An in-house team of licensed review agents, registered nurses, and a board-certified physician review cases to ensure proper treatment.

Employee training and resources

Members can get digital resources like articles on the InsideRM blog, forms in the member library, and online training with the SafeSchools courses. A program consultant trains new members and offers guidance on workers' compensation compliance.

Compliance and high tier performance

The Fund stays current on regulations to ensure claims are adjusted timely and properly. In fact, the program has been named a High Tier performer by the Texas Department of Insurance every year since the rating’s start in 2007.

Flexible funding options

We offer three ways to take advantage of Workers’ Compensation coverage:

  • Fully-funded plan: a contribution covers administration, loss prevention, stop-loss coverage, claims handling, and medical cost containment. All claims are paid; there are no extra fees.
  • Aggregated deductible plan: a reduced contribution covers claims after the total deductible level is met.
  • Administrative services only plan: there is a claims administration fee and the organization reimburses the Fund for claims paid.

Contact your marketing consultant to find out more about Workers' Compensation coverage.