!!! Make sure to have pen and paper on hand!!!

Report all workers’ compensation injuries immediately by calling 1.888.925.2990 and pressing 5. You will be connected with Progressive Employer Management Company’s (PEMCO) workers’ compensation carrier who will collect the information about your injured employee and initiate the claims process. Representatives are available 24 hours a day, 7 days a week, to assist you. Any workers’ compensation injury should be reported by the business owner or designee as soon as possible, and in all cases within 24 hours of the occurrence of the accident.

If the injury is life threatening, call 911 or seek treatment at the nearest hospital.


Claims Reporting Steps:
  1. Complete the Accident / Injury Report Form (included in this packet). You will need this information when you report the claim.
  2. Call 1.888.925.2990 and press 5 to report the claim to our Carrier representative. Notify the representative that you are a client of Progressive Employer Management Company and provide them with our policy number: WC0110484.

a.. You will be given a claim number at the end of your call. Be sure to make note of this claim number on the Accident / Injury Report form and include it on the Treatment Authorization to ensure the claim is handled in a timely manner.

b. The Claims representative will provide you with a list of authorized facilities in your area where you can send your injured employee for treatment.

3. Complete the following forms and send them with the injured employee to the treatment facility.

a.. Treatment Authorization

b.. Pharmacy First Fill Authorization

4. Remind your injured employee that a post-accident drug test will be performed at the treatment facility.

TREATMENT AUTHORIZATION:

The Treatment Authorization is included in this claim packet. Please make additional copies as needed. This form must be completed and taken to the treatment facility by the injured employee in order to ensure the timely payment of claims related medical bills. Please provide all requested information on the form including the claim number that you receive when reporting the claim.

PHARMACY FIRST FILL PROGRAM:

The First Fill Program is a single-use pharmacy authorization that provides an immediate solution for an injured worker’s initial prescription needs. When an injury is reported, complete the Optum temporary pharmacy authorization card and give it to the employee to take with them when they go for treatment. This program ensures the injured worker receives their initial medications as soon as possible with no out-of-pocket expense and is accepted at most major pharmacies. To complete the Optum Prescription Drug Card, simply fill in the following information:

 Member ID which is a combination of the last four digits of the injured employee’s social security number plus the date of injury (DOI).

 Member Name which is the injured employee’s first and last name.

ACCESSING A PROVIDER FOR TREATMENT:

The Carrier representative will provide information about the nearest authorized treatment facilities for your injured employee. If you have additional questions or would like to have a directory provided to you, please contact the PEMCO Claims Team at claims@progressiveemployer.com or 1.888.925.2990 x 20808. If you are located in Georgia, refer to your Physician Panel list for treatment facilities within your area. If you have worksites in Georgia and do not have a Physician Panel, contact us at claims@progressiveemployer.com and we will assist you in obtaining one.

QUESTIONS / SUPPORT:

If you have any questions about claims reporting, please contact your Client Relations Manager or the Claims Team at Progressive Employer Management Company (PEMCO).

Claims Team email: claims@progressiveemployer.com

Claims Team phone: 1.888.925.2990 x20808

Electronic copies of this Claims Reporting Procedure, as well as the referenced forms, can be found on PEMCO PULSE (www.pemcopulse.com) under the Forms section for download and printing as needed.