Participant Rights and Responsibilities - OneNet PPO Supplement, 2018 UnitedHealthcare Administrative Guide

Get a copy of current OneNet Workers’ Compensation Participant Rights and Responsibilities, which vary from UnitedHealthcare’s Member Rights and Responsibilities, by calling Procura at 877-461-3750.

Advance Directives

Follow the advance directive requirements provided in the UnitedHealthcare guide for the OneNet Workers’ Compensation Network, if applicable. OneNet does not produce workers’ compensation benefit materials for injured workers.

We cannot inform OneNet Participants of state laws on advance directives. This is the responsibility of the employer, workers’ compensation carrier or administrator.

Participant Appeals, Grievances or Complaints

OneNet participants should direct appeals or grievances to their Payer or administrator. They do not use the Appeals and Grievance Form used by UnitedHealthcare members. You are required to support the Payer’s appeals process by providing records as requested and complying with final determinations.

In the case of complaints or grievances related to a participating care provider, the payer or administrator refers the information to UnitedHealthcare and OneNet.