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MCO Contact TablesJanuary 20211-888-OHIOCOMP10041To Report an InjuryTo Submit MedicalTo Send OCOMP2900 Carnegie AveCleveland, OH 44115Address1-888-OHIOCOMP2900 Carnegie AveCleveland, OH 44115Medical Documentation Fax:216-426-0651888-644-7339Billing Fax:216-426-0651888-644-7339Case ManagementSupervisor:Lynn Popovich, RN, BSN, CCMPhone: 216-426-0646Ext 1184Billing DepartmentMegan WashingtonPhone: 1-888-644-6266 Ext 1376Email: 888-644-7339Electronic Billing Info:Clearinghouse: Quadax or Relay HealthFormats accepted: 837 v5010Contact:Len Stusek (Quadax)440-777-6300800-527-8133 General Information: Phone: 888-644-6266Email Address: info@1-888-ohiocomp.com1
3-HABwww.3hab.com10013To Report an InjuryTo Submit MedicalTo Send BillsPhone513-221-3422, or800-869-1871Address3-HABAttn. Care CoordinatorP.O. Box 429540Cincinnati, Ohio 45242-9540info@3hab.comAddress3-HABAttn. Billing CoordinatorP.O. Box 429540Cincinnati, Ohio 45242-9540info@3hab.comMedical Documentation Fax:513-221-2338800-869-1872Billing Fax:513-221-2338800-869-1872Case ManagementSupervisor:Nicole C.800-869-1871 ext.3207Billing SupervisorMelony R.melonyr@3hab.com800-869-1871ext 3252FAX513-221-2338800-869-1872Electronic Billing Info:Clearinghouse: AlveoFormats accepted: 5010Contact:Brigott Dawn800-327-1213bdawn@alveohealth.comGeneral Information: 800-869-1871Email Address: info@3hab.com2
AultComp MCO, Inc.To Report an InjuryPhone:888-738-5800 or330-830-4919Fax:330-830-4900877-738-005810016To Submit MedicalAddress:AultcompPO Box 36149Canton, OH 44735-6149To Send BillsAddress:AultcompPO Box 36149Canton, OH 44735-6149Medical Documentation Fax:330-830-4900877-738-0058General BillingInquiries:888-738-5800330-830-4919Case ManagementSupervisor:Vicki Bouscher330-830-4919Billing Contact:Lisa O.lisa.o.1@aultcompmco.com330-830-4919 x117Billing Fax:330-830-4900877-738-0058Electronic Billing Info:Clearinghouse used: AlveoFormats accepted: ANSI 837Contact:Todd Cropper 888-738-5800 ext. 112Brigott Dawn 800-327-1213General Information: 330-830-49193
CorVel Ohio MCO, Inc.www.corvel.com10008To Report an InjuryTo Submit MedicalTo Send BillsPhone:800-275-6463Address:CorVel Ohio MCO, Inc.P.O. Box 3758Dublin, Ohio 43016-0389Address:CorVel CorporationP.O. Box 3758Dublin, OH 43016MedicalDocumentation Fax:503-205-1753877-677-6756General Phone Number:800-275-6463Fax:503-205-1753Utilization ManagementPhone:800-275-6463Case Management Manager:Diane Pritchard800-275-6463 ext. 79397Diane Pritchard@corvel.comBilling Fax:503-205-1753877-677-6756Billing Manager:Carla Geary, CPC, Bill ReviewManagerT 800-275-6463 F 877-677-6756ohiomcobilling@corvel.comElectronic Billing Info:Clearinghouse: Insuraware Data Services,Trizetto/CognizantFormats accepted: NSF 2003; X.12 formats837, 835, 276, 277, 278, 824; versions 3051,5010, 6010Contact: Derek Scranton, ComplianceManager800-275-6463 ext. 79407General Information: 800-275-6463Email Address: Chris Herrington@corvel.com4
GENEX Care for Ohiowww.genexservices.com10042To Report an InjuryTo Submit MedicalTo Send BillsPhone:800-447-6250ext. 17672Address (Utilization/MedicalManagement):GENEX Care for Ohio11590 Century Blvd., Suite 202Cincinnati, OH 45246Address:GENEX Care for Ohio11590 Century Blvd., Suite 202Cincinnati, OH 45246Fax:610-964-5227888-275-9719For Billing Customer ServicePhone:800-447-6250 ext. 17638Billing Fax:610-964-5227888-275-9719Phone:800-447-6250 ext. 17637Medical Documentation Fax:Fax: 610-964-5227888-275-9719Case Management Supervisor:Cheryl Henderson RN, CCMCheryl.Henderson@genexservices.com800-447-6250 ext. 17658Manager:Angela Houston, RN, CCMAngela.houston@genexservices.com800-447-6250 ext. 17655General Information: 513-346-7880 ext. 17657 or 800-447-6250 ext. 17657Email Address: joanne.reasinger@genexservices.com5Billing Contacts:Don Dudash, CPCDonald.dudash@genexservices.com800-447-6250 ext. 17638Val MillerValerie.miller@genexservices.com800-447-6250 ext. 17672Electronic Billing Info:Clearinghouse: Jopari Acct. # J1895Formats accepted: EDI ANSI X12 837versions 4010 and 5010Contact: Colleen Berry, Director,Payer Technologies925-429-4821
Health Management Solutionswww.hmssolutions.com10006To Report an InjuryTo Submit MedicalTo Send BillsPhone:614-799-0898 or 888-202-3515(8:00 a.m. - 5:00 p.m.)After hours, select option 3Address:Health Management Solutions2545 Farmers Drive, Suite 400Columbus, OH 43235Address:Health Management Solutions2545 Farmers Drive, Suite 400Columbus, OH 43235Address:Health Management Solutions2545 Farmers Drive, Suite 400Columbus, OH 43235Medical Documentation Fax:614-889-6246888-303-6294Billing Fax:614-889-6246888-303-6294Corporate Address:1901 Indian Wood CircleMaumee, OH 43537Case Management:Anne Grossman Csaszar888-202-3515 ext. 3-6294Billing Contact:Anne Grossman Csaszar888-202-3515 ext. 300507Anneg@hmssolutions.comElectronic Billing Info:Contact: Michael Pulsfort(614)889-8061General Information: 888-202-3515Email Address: Anneg@hmssolutions.com6
Occupational Health Link Inc.To Report an 81www.oehpmco.com10017To Submit MedicalAddress:Occupational Health Link445 Hutchinson Ave., Suite 205Columbus, OH 43235To Send BillsAddress:Occupational Health Link445 Hutchinson Ave., Suite 205Columbus, OH 43235Medical Documentation Fax:614-318-1095888-240-6381Phone:888-844-0039Case Management Supervisor:Bryony Burton888-844-0039 ext. 1014bryonyb@oehpmco.comGeneral Information: 888-844-0039Email Address: karenc@oehpmco.com7Billing Fax:614-318-1095877-605-8311Billing Team Email:Crystal Webb, CPCcrystalw@oehpmco.com888-844-0039 ext. 1035
Sedgwick Managed Care Ohiowww.sedgwickmco.comTo Report an InjuryTo Submit MedicalTo Send BillsPhone (24 hours)888-627-7586 Option #2Address:Sedgwick MCOP.O. Box 1040Dublin, OH 43017Address:Sedgwick MCOP.O. Box 1040Dublin, OH 43017Medical Documentation Fax:888-627-0074Billing CustomerService Phone:888-627-7586 Option intro/Customer Service Phone:888-627-7586Case ManagementSupervisor:Deb Billing Contacts:Cindy 0-3659Judy ng Fax:888-627-0074Electronic Billing Info:Clearinghouse: Change HealthcareFormats accepted: X12 837v5010Contact: 615-932-3000 orwww.changehealthcare.comGeneral Information: 888-627-7586Email Address: medical@sedgwickmco.com8
Sheakley UniCompwww.sheakley.comTo Report an InjuryTo Submit MedicalTo Send BillsPhone:888-743-2559 or513-618-1249Address:Sheakley UniCompOne Sheakley Way Cincinnati,OH 45246Address:Sheakley UniCompOne Sheakley WayCincinnati, OH 45246Medical Documentation Fax:513-326-8005888-626-2667Billing Contact:Kimberly Hairstonkimberlyh@sheakley.com888-743-2559 ext. 7010Fax:513-326-8005888-626-266710002Case Manager Team Leader:Shonda Bedelshondab@sheakley.com888-743-2559 ext. 7222Billing Fax:513-326-8005888-626-2667Electronic Billing Info:Clearinghouse: Relay HealthFormats accepted: 837 v5010Contact: Ammi K.888-743-2559 ext. 7104General Information: 888-743-2559Email Address: mco@sheakley.com9
Spooner Medical Administrators, Inc.10011To Report an InjuryTo Submit MedicalTo Send BillsPhone:440-899-2400800-542-9479Address:Spooner Medical Administrators,Inc.28301 Ranney ParkwayWestlake, OH 44145Address:Spooner Medical Administrators,Inc.28301 Ranney ParkwayWestlake, OH 44145Medical Documentation Fax:440-899-2411800-542-9480Billing Fax :440-899-2411800-542-9480Case ManagementSupervisor:Ed S, RN, CCM440-899-2400 ext. 231edwards@spoonermai.comBilling Contact:Tonya O., CPC, CPC-H440-899-2400 ext. 80Electronic Billing Info:Formats accepted: 837 v5010Contact: Mike D.440-899-2400 ext. 310miked@spoonermai.comGeneral Information: 800-542-9479Email Address: lisal@spoonermai.com10
Sheakley UniComp www.sheakley.com 10002 To Report an Injury To Submit Medical To Send Bills Phone: 888-743-2559 or 513-618-1249 Fax: 513-326-8005 888 -626-2667 Address: Sheakley UniComp One Sheakley Way Cincinnati, OH 45246 Medical Documentation Fax: 513 326 8005 888-626-2667 888 Case Manager Team Leader: Shonda Bedel shondab@sheakley.comFile Size: 738KB
