Skip to content
Find Provider
Referrals
Preauth
Bill Status
Find a Provider
Submit Referral
Preauth Request
Bill Status
Search for:
About
About IMO
Resources
Satisfaction Surveys
Careers
Solutions
IMO Med-Select Network
MedCare Services
Utilization Review
Nonsubscriber Services
Medical Bill Review
Industry Care Programs
Case Management
Ancillary Services
Lighthouse Resource Group®
SmartCat® Software
Provider Resources
Injured Employees
Business Services
IMO Connect
Contact
Adjuster Satisfaction Survey
Adjuster Satisfaction Survey
MedingenuityAdmin
2020-05-29T17:46:06+00:00
*** This form is for
ADJUSTER
use only. IMO Med-Select Network
®
Claims Only. ***
The Network Case Manager (TCM) kept me informed of medical and return-to-work plans at onset and during the network process
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The injured employees are able to get in to see a network treating doctor within a reasonable amount of time
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I was made aware of medical concerns and/or changes in the medical condition timely
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Generally speaking, injured employees have provided positive network feedback
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The network doctor/clinic provides required DWC73 forms in a timely manner
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
If the injured worker was unable to return to work full duty, the network doctor worked with the employer to get the injured worker back to work on transitional duty, if available
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Referrals to physical therapists, specialists and diagnostic facilities were handled timely
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
General Comments or Suggestions
Name of Employer
*
We do not use this information to identify you. This is only used to correctly identify the employer.
Please contact me for further comments
Yes
No
Name
Phone
Email
Page load link
