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Employer Satisfaction Survey
Employer Satisfaction Survey
MedingenuityAdmin
2020-04-27T21:11:22+00:00
*** This form is for
EMPLOYER
use only. IMO Med-Select Network
®
Claims Only. ***
Your 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
The network doctor/clinic provides required DWC 73 forms in a timely manner
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
If the injured worker was unable to return to work full duty, transitional duty was discussed
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Referrals to physical therapists, specialists and diagnostic facilities were handled in a timely fashion
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Generally speaking, injured employees have provided positive feedback regarding their experience with their network treating doctor
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The IMO Telephonic Case Manager (TCM) kept you informed of medical and return to work plans at the onset and during the network process
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The IMO Med-Select Network has facilitated a positive impact in coordinating the medical treatment plan and RTW successful outcome
*
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
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