Compmanagement Health Systems, Inc. Injury on the Job Claim Procedures

Employer Name & Rise#/Policy # Coordinator:
Name: Kenyon College
Address: Eaton Center
City, State, Zip: Gambier, Ohio 43022
Risk Number: 30095

Your WC Coordinator
Name: Mary Goble
Title: Human Resources Specialist
Phone: (740) 427-5173
Fax: (740) 427-5901

If you experience a Job Injury:

1. Report the injury/incident to your supervisor and complete all necessary paperwork. Your supervisor will give you additional instructions as needed.
2. Your WC Coordinator can provide additional written or verbal instructions.
3. We ask that you seek medical attention from the Anchor Medical Group listed below. You may seek treatment from any provider. However, the provider must be BW certified to receive payment from CHS.
4. Give your MCO Identification Card, provided by your supervisor, to the medical provider to ensure all bills and necessary documents are sent to the correct address.
5. Notify your employer of your medical condition.
6. Keep your WC Coordinator informed on the status of your injury.

See your supervisor or WC coordinator for all necessary forms.

Anchor Medical Group(s):

(Non-Emergency)	(Emergency)
Mid- Ohio Corporate Care	Knox Community Hospital
1330 Coshocton Road	1330 Coshocton Road
Mount Vernon, OH 43050	Mount Vernon, OH 43050
(740) 393-WORK (9675)	(740) 393-9000
M - F 8 am - 5 pm	24 Hours

MANAGED CARE ORGANIZATION:
CompManagement Health Systems, Inc.
PO Box 1010
Dublin, Ohio 43017
Phone: 614-799-1260
Toll-Free: 888-247-7799
Fax: 614-718-9870
www.chsmco.com