MetraComp – Network Information

MetraComp New York Provider Update

Certified PPO

A certified PPO is a plan certified by the Department of Health, owned, operated or administered by an entity that has the capacity to establish a network of service providers that provides or arranges for the coordination and delivery of all required services.

Benefits of a certified PPO model include:

  • Direction of Care for 30 days from the first visit with a PPO provider
  • Discounted fee arrangements with PPO participating providers
  • Mandatory care management including Utilization Review, Return-to-Work, and Telephonic and Field Case Management
Learn more about our Certified PPO model
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Recommendation of Care

A Recommendation of Care model is defined as actively endorsing or promoting the use of a designated network or health care provider(s) for the treatment of an injured employee.

Benefits of a Recommendation of Care model include:

  • Initial treatment required with a PPO provider (except for emergencies) 
  • Carrier/employer may recommend the network to all injured workers
  • PPO discounts available on all claims where ROC rules have been followed
  • ROC program may be used in non-certified counties
  • Existence of carrier/network contract is considered recommendation of care even if not actively recommending
Learn more about our Recommendation of Care model
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