Physicians accredited with Saskatchewan Health are concurrently accredited with the WCB and, therefore, are not required to apply for accreditation with the WCB.
Accreditation
WCB Standards and Requirements
Authorization to treat
Treatment
Billing
Payments
Reporting
Accreditation
Physicians are automatically authorized to treat WCB clients and to bill the WCB directly for their services.
The WCB relies on all health care providers to ensure that:
- all workplace injuries requiring medical aid are reported promptly;
- all treatment is necessary and consistent with established agreements; and
- all invoices are appropriate. More
WCB Standards and Requirements
When treating WCB clients, health care providers assume certain
roles and responsibilities.
In treating WCB clients, physicians will:
- Comply with all requirements of the College of Physicians and Surgeons and Saskatchewan Health Medical Services Branch (MSB);
- Bill the WCB in accordance with the WCB fee schedule as agreed to by the Saskatchewan Medical Association (SMA); and
- Demonstrate ethical practice standards on a day-to-day basis, including disclosure to any perspective WCB client of any business relationship you may have with their employer. This allows the worker to make an informed decision regarding their choice of care provider.
Authorization to Treat
Physicians accredited with Saskatchewan Health are authorized to treat WCB clients. Authorization is only required for procedures that are not funded by Saskatchewan Health.
As primary care providers, physicians may refer WCB clients to other care providers. Referrals must identify the medical limitations and goals and objectives of treatment. Please note: Referrals do not constitute authorization to treat. If you refer WCB clients to non-physician providers, the providers must contact the WCB for authorization to treat the referred clients on a file-by-file basis.
Treatment
If the injured worker's recovery does not progress, contact the WCB to request advanced
assessment and treatment, or
expedited appointments, if required. See also
Disability Duration Guidelines.
Return to work should generally be part of each worker's treatment plan. For more information, see our
Recovery and Return to Work brochure.
Billing
- Physicians invoice the WCB for services provided to WCB clients using the Doctor's Billing (DOC) form or reasonable facsimile following the Saskatchewan Medical Services Branch (MSB) payment schedule and assessment rules;
- Payments for non-MSB insured services and reporting fees are established by the WCB in negotiation with professional associations representing physicians, chiropractors and physiotherapists, etc. Non-MSB service fees are included in the WCB's fee schedule; and
- Because the WCB and MSB do not have a reciprocal billing process, invoices sent incorrectly to either insurer will be returned for resubmission.
To speed up payment for services:
- Retain your daily record of services provided in case of an audit;
- List all services and service dates on the Doctor's Billing (DOC) form;
- Follow the fee schedule agreed to by your professional association;
- Forward the completed DOC form to the WCB. If you prefer to use a different format, make sure to include all the information requested on the sample; and
- Submit a Direct Deposit Application to receive your payments by electronic transfer.
Payments
The WCB issues payment to caregivers weekly and provides vouchers detailing the payments that were issued. These vouchers may include
explanatory codes to provide detail regarding specific services. The WCB will also provide a monthly summary of all payment made to you by cheque or direct deposit.
Disallowed Claims
When an injury claim has been disallowed or benefits terminated, physicians will be notified that the WCB cannot pay for further assessment or treatment. The WCB will only pay for treatment to date of notice of termination. The WCB will also pay reporting fees to date of notice.
Details of payment are provided weekly to each caregiver, including those on Direct Deposit.
Direct Deposit
You can apply to have all payments from the WCB deposited by electronic transfer into your bank account. Each clinic's deposit can be directed to a different bank account, if you wish, in which case, a separate
direct deposit application is required for each clinic from which you submit WCB claims.
E-Business Transactions
As an accredited WCB care provider, you can access information about your WCB payments through our secure @WCB
Online Services. To use this service, you must first apply for an @WCB e-business account by clicking
here. Read the disclaimer, check the box at the bottom and click "I agree". Provide your email address and a security password.
Once your @WCB account is approved, you can conduct the following secure transactions at your convenience:
- view payment history;
- view file information about clients the WCB has referred to you;
- update treatment lists;
- report an injury;
- report injury progress;
- review forms you have submitted; and
- give your billing clerk, accountant or others access to your account.
Clinics may also apply for @WCB secure access to:
- view Voucher Details;
- download Voucher Details; and
- search for cheque information
Reporting Requirements
Under
Section 54-56 of the Saskatchewan Workers' Compensation Act, 1979, care providers are required to provide reports to the WCB and do not require a signed release from the worker to do so. Early and regular care provider reports are important to the worker and the WCB because:
- The WCB requires client medical records to process claims and appeals; and
- The WCB may need to provide copies of reports to other health care providers, i.e., Assessment Teams, Treatment Centres and specialists to assist in obtaining the best possible assessments and treatments for injured workers.
You should advise injured workers that their medical records may be made available to their employers or others if their claims are appealed.
Initial Report of Injury
Primary practitioners are required to submit a
Primary Practitioner's Initial Report (PPI) for all injuries, including those that do not result in time off work. Where the injured worker loses time from work because of an injury, the PPI provides confirmation of disability, which allows the WCB to arrange timely payment of benefits to injured workers. Prompt reporting is important to prevent financial hardship for the injured worker and family.
Progress Reports
A
Physician's Progress Report (PPP) should be completed whenever the worker's condition, diagnosis or treatment changes, or when there is a need for a medical review. A report approximately every three weeks allows for payment of timely wage-loss benefits for the injured worker.
Other Reports
Copies of special reports - diagnostic, operative, etc. - should always be forwarded to the WCB. They provide the WCB with relevant information, and save the attending practitioner from preparing a separate report.
Report Fees
Reporting fees are paid by the WCB where the physician invoices the appropriate fee. If more than one report is received in the same day, only one report fee is paid. The WCB will not pay for illegible or incomplete reports.
