NOTICE TO EMPLOYEES
Saint Joseph's University
Philadelphia, Pennsylvania 19131
Your employer has provided for the payment of benefits under the Workers' Compensation Act of this State
IN CASE OF WORK-RELATED INJURY· If you suffer a work-related injury, your employer or its insurance company must pay for reasonable surgical and medical services and supplies, orthopedic appliances and prostheses, including training in their use.· In order to ensure that your medical treatment will be paid for by your employer or the insurance company, you must immediately advise your supervisor of your injury, and be treated by one of the licensed physicians or practitioners of the healing arts listed below:
(including address, telephone number, and area of medical specialty)
Worknet Occupational Medicine - Occupational Medicine Clinic
5800 Ridge Avenue, Suite 234, Philadelphia, PA 19128
Mercy Workcare At Mercy Hospital Of Philadelphia - Occupational Medicine Clinic
501 South 54th Street, Philadelphia, PA 19143
Crozer Center For Occupational Health - Occupational Medicine Clinic
127 W Chester Pike, Havertown, PA 19083
Angeloni, John, DO - City Line Family Medicine
301 E City Ave #100, Bala Cynwyd, PA 19004
McKenzie, Judith G., MD
Hup Department Of Emergency Medicine
3400 Spruce St, Ground Floor, Silverstein Bldg, Philadelphia, PA 19104
PCOM Family Medicine
4190 City Ave #315, Philadelphia, PA 19131
Baldino, Vincent, DO - Ritner Medical Associates
1701 Ritner Street, Philadelphia, PA 19145
Rubenstein, David, MD - Main Line Orthopaedics & Sports Medicine
100 E Lancaster Ave #650, Wynnewood, PA 19096
Surgicorp, LTD - Surgery/General
4190 City Avenue #509, Philadelphia, PA 19131
Caplan, Howard J., MD - Neurology
100 E Lancaster Avenue, Lankenau Medical Bldg East , Suite 463, Wynnewood, PA 19096
MEDRISK - Novacare Rehab
100 Presidential Blvd, Bala Cynwyd, PA 19004
Nevyas, Herbert J., MD - Nevyas Eye Associates
333 E City Avenue, 2 Bala Plaza, Bala Cynwyd, PA 19004
Rebisz, Brian, DC - Highland Park Chiropractic Center
8420 West Chester Pike, Upper Darby, PA 19082
TMESYS Pharmacy Program - To contact your local TMESYS Pharmacy, please call (800) 964-2531
You must continue to visit one of these persons listed above, if you need treatment, for ninety (90) day from the date of your first visit. If you do not, your employer may not be required to pay these services.
After this ninety (90) day period, if you still need treatment and your employer had provided a list as set forth above, you may choose to go to another licensed physician or practitioner of the healing arts for treatment. You must notify your employer of this action within five (5) days of your visit to the person of your choice, or your employer may not be required to pay for these services.
Your bills will be paid for IF: your licensed physician or practitioner of the healing arts files reports as required. (These reports must be filed within ten (10) days after your first visit and at least once a month for as long as treatment continues.)· In the event a posted panel physician recommends invasive surgery, you may seek a second opinion with a physician of your choice. If you choose to undergo the invasive surgery, you must use a posted physician for the treatment.
If no list is provided as above, you may go to a licensed physician of practitioner of the healing arts of your choice.If one of the persons listed above refers you to another licensed specialist, your employer or his insurer will pay the bill for these services.· If you are faced with a medical emergency, you may secure assistance from a hospital or physician or practitioner of the healing arts of your choice.
Notify your immediate supervisor of your injury. If you feel that you need medical attention, you may choose one of the providers listed here. Please call the provider to confirm Coventry participation and to schedule an appointment for faster service. Many clinics are open extended hours for your convenience. For urgent care needs after clinics hours, you may proceed directly to the hospital listed here.
Patients will be seen on a medical priority basis. In emergency situations you may immediately seek treatment from the nearest qualified facility or provider. IF YOU NEED AN ALTERNATE TO THE PROVIDERS LISTED HERE, CALL 888-476-2669.Your Employer and its Insurance Carrier utilizes Coventry contracted providers. The above list is not a complete list of healthcare providers with Coventry. For a complete listing of providers, or to verify whether a particular doctor does participate, please call 800-289-2389.If your situation is a medical emergency requiring immediate attention, dial 911 or proceed to the nearest hospital which provides emergency services. Use of network does not confirm or verify compensability under the Workers' Compensation Act, which is determined solely by the claims administrator.
REMEMBER, IT IS IMPORTANT TO TELL YOUR EMPLOYER ABOUT YOUR INJURY