PROVIDER NETWORK RULES for ILLINOIS

Provider Selection
General Rule: The employee may choose a provider for initial care either from the employer’s posted panel of providers or a provider not included on the employer’s panel. 820 ILCS 305/8. First aid and emergency care are not considered an initial choice of provider. http://www.iwcc.il.gov.

Managed Care Options
General Rule: The employee may elect to change providers one time at the employee's own discretion. A subsequent change of treating provider is subject to employer or insurer approval. Referrals to specialists are not considered a change in treating physician. http://www.iwcc.il.gov.

Provider Lists
Panels and Directories are allowed, subject to the approval of the Illinois Workers' Compensation Commission. There is no state-mandated panel form.


PROVDER NETWORK RULES FOR ILLINOIS – PPP


Provider Selection
The employee chooses the treating provider from a list of network providers.

Managed Care Options
An employer may use a preferred provider program (PPP) approved by the Illinois Department of Insurance.

Provider Lists
Provider lists and directories are allowed.