By discipline: Hearing Service Providers
Before you can provide audiology services to WCB customers and bill the WCB directly for those services, you must:
- Be accredited by the WCB.
- Contact the WCB to get authorization to treat the customer and determine what services WCB will fund.
To apply for accreditation with the WCB:
1. Read the Practise Standards for Audiologists Providing Services to WCB Customers carefully;
2. Complete, print and sign the Accreditation Request form. Attach to this form proof that you are either:
- An audiologist currently licensed and in good standing with the Saskatchewan Association of Speech Language Pathologists and Audiologists.
- A hearing instrument practitioner currently registered and in good standing with a professional association that is registered as a non-profit organization.
- A graduate of a minimum 2-year program at an accredited university or technical school with a directly supervised practicum of 840 hours.
Also include copies of the following documents with your form:
- The degree, diploma, etc. that the educational institute you attended issued to you.
- Your current and valid license issued to you following the guidelines in The Hearing Aid Sales and Services Regulations.
3. Fax this information to the WCB’s Health Care Services department at the fax number on the form.
Note: The WCB can not process incomplete applications.
The WCB’s Health Care Services department will review your accreditation application. You will receive a letter in the mail indicating if your application has been accepted or not. If you are accepted, your name will be added to the WCB’s Approved Providers List. You will also receive your WCB billing number by mail. Your accreditation is non-transferable. You are only accredited to work in the clinics you list on your application. The WCB can not issue payment for care at a clinic if either the provider or clinic is not accredited prior to care being provided. If you wish to add a clinic to your portfolio, you must submit a separate accreditation request for that clinic.
You must get approval from WCB to treat WCB customers. Don’t rely on customers for authorization because they may think their claim number means WCB has agreed to pay for their treatment.
To get approval, complete the Primary Authorization to Treat – Hearing Services form and either mail or fax it to the WCB. If you don’t get approval before treating, your services may not be paid for by the WCB.
(Note: If the patient’s claim is later denied after you received approval, the WCB will notify you and pay for treatment that we approved up to the date of the termination notice. The WCB will also pay reporting fees to date of notice.)
To prevent financial hardship to a WCB customer, bill the WCB directly for approved services and appliances. You can only bill workers for the difference in costs if they want a more expensive model than the one approved for them by the WCB.
To direct bill, you will need the WCB billing number you or your clinic received when your accreditation application was approved. The WCB will not pay for services or appliances provided before your accreditation date or provided at a clinic where you have not been accredited.
Payment can only be issued if the invoice meets the criteria. The following information is required:
- Worker’s name
- Worker’s address
- Provincial health number
- Date of birth
- Date(s) of service
- Care provider number
- Clinic number
- Hearing Service Provider’s name
- Hearing Service Provider’s address
- Hearing Service Provider’s phone and fax number
- Fee code(s)
- Fee code amount(s)
- Number of units
Retain your daily record of the service you provide to our customers in case an audit is required.
The WCB will not pay any account rendered by a physician, surgeon, hospital or other health care professional or institution for medical aid service if application for payment is received by Operations or Medical Accounts after twelve-month period from the time the medical aid is administered to an injured worker. See Procedure PRO53/2006.
Bill costs should match the fee schedule for Hearing Service Providers.
Under legislation, care providers do not require a signed release from an injured worker in order to provide medical information to the WCB:
- WCB staff need customers’ medical records to process claims and appeals.
- The WCB may provide copies of reports to other health care providers to assist in obtaining the best possible assessments and treatments for injured workers.
In the case of an appeal, a worker’s records may be made available to an employer or others, but only with the worker’s approval.
Please review WCB’s Guidelines to Establish Traumatic and Occupational Noise-Induced Hearing Loss Claims.
To establish hearing loss, submit a Primary Level Authorization to Treat – Hearing Services form to the customer’s Case Manager along with:
- The customer’s audiogram.
- Your recommendation for an entry-level hearing aid. (If the customer needs a mid-range or premium product, you must provide medical justification of why this is required.)
Once WCB Operations staff have confirmed and approved the claim, you can provide the customer with the hearing aid. WCB will only cover the cost of an approved entry-level or basic hearing aid, except where a worker has a medical need for another aid. If injured workers want a more expensive model than the one WCB approved, you can directly bill the worker for the difference in costs.
You will still need to submit a Primary Level Authorization to Treat – Hearing Services form for other services you may provide the customer, including repairs to their hearing aids. For each new fitting, you need to conduct at least one follow-up visit with the customer (maximum of two visits per year.)
You do not need to submit the form before providing new batteries to customers who have hearing aids funded by the WCB.
When treating WCB customers, health care providers assume certain roles and responsibilities.
The WCB relies on all health care providers to make sure:
- All workplace injuries requiring medical aid are reported promptly.
- All treatment is necessary and consistent with established agreements.
- All invoices accurately reflect the services provided.
When treating WCB customers, you should:
- Know the guidelines listed in Practise Standards for Audiologists Providing Services to Saskatchewan WCB Customers, as well as WCB billing and reporting requirements.
- Get approval before treating WCB customers on a file-by-file basis.
- Follow the practise standards and fee schedule created for hearing service providers.
- Demonstrate ethical practise standards on a day-to-day basis. This includes informing any potential WCB customer of business relationships you may have with their employer, so the worker can decide whether they want to choose you as a care provider.
- Avoid mentioning in you or your clinic’s advertisements that you treat WCB customers or you are affiliated with the WCB in any way.
To ensure that Practise Standards for Audiologists Providing Services to Saskatchewan WCB Customers is being followed, WCB may conduct compliance surveys. You will receive a notice from WCB 2 weeks before you, your clinic, or your treatment centre receives its compliance survey.