Insurer Resources

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  • Oregon
  • Wyoming
  • Texas
  • Montana

Majoris is dedicated exclusively to the workers’ compensation sector, offering programs designed to enhance care delivery and expedite recovery for injured workers. As a state-certified MCO, Majoris is authorized to determine medical necessity and direct workers into a specialized network. Our proactive model employing board-certified physicians for all utilization review decisions ensures care is expertly managed. We excel in developing curated networks and strategic provider partnerships tailored to the unique demands of workers’ compensation. This approach results in superior worker care, quicker return to work, and improved outcomes. Learn more about our solutions here.

If you have questions or concerns regarding a precertification request or overall worker care, please contact the assigned Majoris claim rep to discuss.

Oregon Managed Care 101

Answers to commonly asked questions regarding Managed Care in Oregon and Majoris Health Systems.

Oregon Dispute Procedures

General information about disputes and the procedure for submitting and processing.

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At Majoris, we specialize in developing curated networks and forging strategic provider partnerships. For employers who have waived coverage through the Wyoming workers’ compensation system, we provide a network tailored to their injured employee benefit program. Our approach enhances workplace injury programs, delivering superior employee experiences and facilitating a faster, more effective injury recovery.

Our programs are developed for each individual employer. To learn more about what we can build for you, please contact [email protected] or call (800) 525-0394.

To find a network provider, please click here.

To submit inquiries or dispute a Majoris action, please email [email protected] or call (800) 525-0394.

At Majoris, we specialize in developing curated networks and forging strategic provider partnerships tailored specifically for workers’ compensation and return-to-work programs. We offer utilization review solutions grounded in proactive case management and interactive peer-to-peer collaboration with our board-certified physician reviewers and treating providers. For Texas non-subscribers, options include leveraging our entire suite of solutions as a comprehensive package or selecting standalone services to enhance your current programs. The Majoris approach integrates seamlessly into your existing framework, delivering superior injured worker experiences, reducing the administrative burden on adjusters, and facilitating faster, more effective injury recovery.

Texas Work Injury Networks

Texas Complaint and Appeal Procedures

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At Majoris, we specialize in developing curated networks and forging strategic provider partnerships. We provide a network tailored to your workers’ compensation and return-to-work programs. Majoris also offers utilization review solutions based on proactive case management and interactive peer-to-peer collaboration with our board-certified physician reviewers and treating providers. For Montana insurers and self-insured employers, options include utilizing our entire suite of solutions as a comprehensive package, or as standalone services to enhance your program.  The Majoris approach integrates into your existing framework to deliver superior injured worker experiences, reduce administrative burden on adjusters, and facilitate faster, more effective injury recovery.

Montana Managed Care 101

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Montana Dispute Procedures

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Find Your Assigned Claim Rep

Use the Claim Rep Lookup link below to get the contact info for the Majoris™ claim representative assigned to a specific claim.

Claim Rep Lookup

Majoris offers a unique medical review process that ensures high-quality care from enrollment to resolution. We proactively monitor key events, maintain regular communication with claims adjusters and managers, and leverage our physician reviewers to handle complex cases. Our approach includes:

  • Proactive File Review Medical Management
  • Medical Treatment Reviews by Board-Certified Physicians
  • Evidence-Based, Peer-Reviewed Guidelines
  • Physician-to-Physician Treatment Collaboration

Additionally, we address common concerns within the workers’ compensation system with innovative programs like our prospective opioid management and sprain/strain programs. This ensures treatment plans and physical restrictions are informed by objective findings, are focused on the work injury, and incorporate a progressive return to work and life activities. The result is higher quality care and significant long-term savings.

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Better networks create better results.

Majoris is selective in the providers we partner with, seeking those who understand the unique demands of treating workers’ compensation patients and who meet high credentialing standards. Our provider relations staff keeps in close contact with our providers to support strong relationships, providing training on workers’ compensation best practices and outreach on individual cases experiencing administrative stall-outs.

When there are questions about treatment, providers can expect to speak with a board-certified physician with a background in treating injured workers. Our outreach is centered on collaboration, with the goal of finding the right treatment plan for each patient’s unique needs.

Credentialing

Credentialing goes beyond confirmation of licensure and malpractice history – we look at past treatment records to ensure there is evidence of sound medical reasoning, reliance on objective medical findings and integration of daily activities and work into the overall rehabilitation plan.

Best Practice Standards

To support their responsibilities as a provider of care to injured workers, Majoris developed a series of guidelines, protocols and techniques to facilitate efficient delivery of care within the workers’ compensation framework. This includes support of other stakeholders’ responsibilities.

Our provider manual offers a road map of best practice, streamlining the flow of required information to reduce effort and administrative burden for all. Our treatment guidelines are derived from evidence-based medicine and specific to the workers’ compensation patient population when the data is available.

All network providers have committed to following these best practices, and our provider relations team provides hands-on support when needed to ensure information is received and timelines are met.

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We utilize sophisticated IT solutions, featuring customized programs and advanced data interfaces. The result is seamless collaboration with all stakeholders and high data integrity. Our cutting-edge technology streamlines operations, enhances communication, and drives effective collaboration.

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