Managed Care Services - OneBeacon Insurance Group

Management of the medical expense portion of a claim is critical. Medical claim costs can escalate quickly, so OneBeacon works with key partners to deploy a full array of cost containment programs. These programs begin immediately after an injury occurs and will continue as long as treatment is medically necessary. Our cost containment programs include:

Preferred provider organizations:

Genex Provider Pathways is utilized for all States with the exception of CA.

  • Accessing the Genex Provider Pathways Channeling Site:
    • Go to: www.genexservices.com.
    • Click Find a Provider/Genex Provider Pathway (top right)
    •  Login with Username: One and Password: Beacon
  • Features:
    • Search for Network Providers by address, name and region
    • Create Work Site Posters

If you have any problems accessing Genex Provider Pathway, Contact GenexProviderPathway@genexservices.com 


Genex Texas Health Care Network (HCN): 
Access to the Genex Texas HCN Program Manual, checklisk and other supporting HCN documentation can be found in our resources section.

 
California MPN

  • To search for providers, please visit: www.coventrywcs.com.
  • Select “Client Login & Tools” in the top right center of the homepage.
    • Enter Client ID: BEA and submit
  • Select channeling tools 
    • Allows you to search for a Network Provider by address, name and region
    • Allows you to create Work Site Posters
  • The requirements for CA employers can be found in the publication: Atlantic Specialty Insurance Company-Select MPN or Rhode Island Employers with California locations.
  • The MPN provides MPN Medical Access Assistants within the United States who are available Monday – Saturday, 7:00 a.m. to 8:00 p.m. Pacific Time to provide employee assistance with access to medical care under the MPN.
California MAA Contact California MPN Contact
Phone: 888.937.1663
Fax: 866.819.8201
Email: CAMPNMAA@onebeacon.com
Jonny Buell
Sr. Claim Representative
Phone: 877.440.6274
Fax: 866.984.5094
jbuell@onebeacon.com

 

Pharmacy First Fill Program - Optum 

  • First Fill Program – A prescription drug card program designed to ensure that the injured worker receives their initial medication as soon as possible after sustaining an injury, even before the claim is accepted as compensable. This program provides access to our national network of over 60,000 pharmacies with NO out-of-pocket costs for the injured worker. There is an $85 cost limit and a 10 day supply limit and the temporary card expires 30 days after the injury.
  • Once a claim is accepted as compensable, generally within 7-14 days, a personalized prescription card will be mailed directly to eligible claimants allowing full refills of covered prescriptions. 
  • Our Pharmacy Benefit Manager (PBM) will absorb the cost of the first fill prescription if the claim is later denied or the medications are unrelated to the injury. OneBeacon covers the costs of the first fill prescriptions for injury related medications that are medically necessary on claims that are ultimately accepted as compensable.