ESIS Medical Impact MPN SM

ESIS provides access to medical treatment in the event you sustain a work-related injury or illness through ESIS Medical Impact MPN. Injured workers can access medical treatment through select Anthem Blue Cross Prudent Buyer PPO ("Blue Cross of California") providers. Anthem Blue Cross contracts with doctors, hospitals and other providers to respond to the special requirements of on-the-job injuries or illnesses.

Provider Directories:

• On-line directories - if you have internet access, you can access the roster of all treating physicians in the MPN by going to the website www.esis.com/awcmpn. A copy of the complete provider listing is also available in writing or electronic copy upon request. Secondary treating physicians and specialists that can only be seen with an approved referral are clearly designated "by referral only" in the online provider finder and roster of all treating physicians.
• If you do not have internet access, you may request assistance locating an MPN provider or obtaining an appointment by contacting the medical access assistant at (844) 622-3747, or via fax at (855) 622 3299 or email at ESISMAA@cvty.us.com.

MPN medical access assistants are available, at a minimum, from Monday through Saturday (excluding Sundays and holidays) from 7 am to 8 pm, Pacific Time, to provide covered employee assistance with access to medical care under the MPN. The assistance includes but is not limited to contacting provider offices during regular business hours to find available MPN physicians of your choice, and scheduling and confirming physician medical appointments. Assistance is available in English and Spanish.

At least one MPN medical access assistant is available to respond at all required times, with the ability for callers to leave a voice message. Medical access assistants will respond to calls, faxes or messages by the next day, excluding Sundays and holidays. MAAs work in coordination with the MPN Contact and the claims adjuster(s) to ensure timely and appropriate medical treatment is available to you. You may contact the Medical Access Assistant at (844) 622-3747, email at ESISMAA@cvty.us.com, and fax (855) 622 3299.

For additional information or copies of the Complete Written MPN Employee Notification, Continuity of Care policy, and Transfer of Care policy please contact the ESIS MPN Contact.

ESIS’ MPN Contact is the individual(s) designated by the MPN who is responsible for responding to complaints, for answering employees’ questions about the medical provider network and for assisting the employee in arranging for an MPN independent medical review pursuant to Labor Code section 4616.4.

MPN Contact Information: