Medical Management

Wecare Managed Care Program

The FHM WECARxE Medical Management Program is a total care management program designed to ensure injured employees’ recovery and return to work. The WECARxE Program increases the quality of medical care by using a total care management concept for treating workers’ compensation injuries.

Employers who use the WECARxE Program:

  • Reduce medical costs by:
    • Taking advantage of FHM’s negotiated discounts with the medical providers.
    • Managing the medical treatment utilized.
  • Reduce medical claim and expense payouts by:
    • Eliminating unnecessary costs.
    • Developing effective Return-to-Work Programs.

WECARxE Benefits

The WECARxE program benefits include:

  • Allowing employers to designate specific network physicians to whom injured employees are referred for medical treatment.
  • Ensuring employees are cared for by physicians who are carefully reviewed based on some of the following factors:
    • Valid license to practice medicine.
    • Valid DEA Controlled Substance Certificate.
    • Admitting privileges at network hospitals.
    • Board certification for appropriate specialists.
    • 24-hour, 7-day-a-week coverage.
  • Incorporating physicians, hospitals and clinics into the care team to promote both the quality and cost-effectiveness of therapeutic treatment.
  • Allowing employers to nominate providers for inclusion in the provider network.

To Begin Using WECARxE

To begin using WECARxE, an employer takes the following steps:

  • Select a Medical Care Coordinator:  The Medical Care Coordinator is the physician and/or clinic or hospital designated by the employer to provide emergency care for injured workers.  Physicians, clinics and hospitals may be chosen from FHM’s approved provider network.  More than one Medical Care Coordinator may be selected.
  • Post the Medical Care Coordinator(s) name, address and telephone number in a prominent place visible to all employees.  Any employee who does not receive treatment from the Medical Care Coordinator may have his/her workers’ compensation benefits denied.
  • Educate each current and new employee on the requirements of the WECARxE Managed Care Program, as well as their rights and responsibilities.
  • Obtain each employee’s signature on the WECARxE Employee Safe Working Practices/Managed Care form, place signed forms in the personnel file of all current and new employees and give each employee a copy of the signed form.
  • Distribute the Grievance Procedure and Formal Grievance Form to all employees and post the procedure near the Medical Care Coordinator(s) information.

To Locate a WECARxE Provider

For help locating a Network Provider in your area or a Medical Care Coordinator in your area, review the FHM Provider Network Directory or contact your Nurse Case Manager or adjuster at 888-346-3461.

When an Accident/Injury Occurs

When an accident occurs the employer should take quick action to arrange for medical care from the Medical Care Coordinator. Any employee who does not receive treatment from the Medical Care Coordinator may have his/her workers’ compensation benefits denied.

  • For emergency (life threatening) medical treatment: The Employer contacts the nearest medical facility.
  • For non-emergency medical treatment:  The Employer arranges for the injured employee to receive medical care by directing the employee to the Medical Care Coordinator and giving the employee the forms listed below:
    • The Introductory Letter to Physician which the employee must take on the initial visit.
    • If the employer is a designated Drug-Free Workplace or participates in the Post-Injury Drug Testing Program, the letter should be modified to request a drug test.
    • The Matrix Pharmacy Form and Pharmacy Instruction Letter if prescription drugs will be required for treatment.
  • Once medical care has been arranged, the employer reports the accident/injury online, via email, fax or telephone to FHM within 24-hours of knowledge of the accident/injury.

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