ARKANSAS WORKERS’ COMPENSATION COMMISSION
324 Spring Street, Little Rock, AR 72201
Mail: P. O. Box 950, Little Rock, AR 72203-0950
501-682-3930 / 1-800-622-4472
Authority: Ark. Code
Ann. § 11-9-514,
AWCC Rule 7, 33
HEALTH CARE NOTICE FOR EMPLOYEES UNDER MANAGED CARE
Your employer has contracted with the following Managed Care Organization (MCO):
or has been certified as an Internal Managed Care System (IMCS). You are required to receive
treatment through this MCO/IMCS if you receive a work-related injury. If you do not receive
treatment through this MCO/IMCS, or you do not obtain permission to change treatment
provider(s), then you may be required to pay for the treatment you receive. Emergency
treatment is exempt from this requirement.
Employees are covered under the MCO/IMCS after the employer posts Form H. Prior notice given
to employees by a certified MCO shall fulfill the above notice requirements.
The telephone number of your employer's MCO/IMCS is . You may call this
number if you have questions about managed care or if you need names of physicians.
If you are injured on the job, you should notify your supervisor immediately. Your supervisor will
arrange for treatment or explain what you need to do to receive treatment for your injury.
If you have a problem with or a dispute about this MCO/IMCS, you may file a complaint within thirty
(30) days of the occurrence. To obtain information contact your supervisor, the MCO/IMCS, or the
Medical Cost Containment Division at the AWCC (1-800-622-4472 or 501-682-3930).
If you are balance billed by a physician for a covered workers' compensation injury, you sh