Physical Therapists 2017-05-11T20:42:23+00:00

By discipline: Physical Therapy

Practice Standards for Care
Soft Tissue Guidelines
Fee Schedule

 

 

On Friday, May 3, 2013, we presented a free webinar for chiropractors and physical therapists on “Essentials to Management of WCB Customers.” We ask that you and your staff to attend a webinar/conference every two years.

View the archived webinar. (Click “Playback” button to view).

To apply for accreditation:

  1. Read the WCB Physical Therapy Practice Standards carefully.
  2. Complete the Accreditation Request – Primary Level Services form, print and sign it.
  3. Attach evidence of your educational credentials.
  4. Attach evidence of current licensure with your licensing body.
  5. Attach evidence of additional educational credentials if you are applying for aerobic assessment and treatment accreditation.
  6. Make sure all documentation is included and fax it to us.

Please note: We cannot process incomplete applications.

Our Health Care Services department will:

  • Review your credentials against the requirements listed in the WCB Physical Therapy Practice Standards.
  • Add your name to the our Approved Providers List, if you are eligible.
  • Notify you by mail as to whether your accreditation request has been accepted or rejected.
  • Provide you with a WCB billing number by mail.

Accreditation is non-transferable
We will accredit you for work in all the clinics you list on your application. However, you must submit a separate accreditation request if you add a clinic to your portfolio or if a clinic changes location. We cannot issue payment for care at a clinic where the provider is not accredited prior to that care being provided.

When treating WCB customers, health care providers assume certain roles and responsibilities.

We rely 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.
  • all invoices are appropriate.

When treating WCB customers, we ask that you:

  • Familiarize yourself with the contents of the WCB Physical Therapy Practice Standards.
  • Refer to the Support Package for Chiropractors/Physical Therapists.
  • Comply with the practice standards and fee schedule established by the WCB with your professional group and all requirements of your licensing body.
  • Demonstrate ethical practice standards on a day-to-day basis, including disclosure to any perspective WCB customer 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.
  • Refrain from using your affiliation with the WCB in any advertising for your services.

To ensure that WCB Physical Therapy Practice Standards are being followed, compliance surveys may be conducted. Treatment centres, clinics and individual practitioners will be notified two weeks before they are to be surveyed and can prepare for the survey by reviewing the survey form and guidelines in advance. Surveys take approximately 1.5 hours and will be conducted by massage therapists, and/or WCB representatives.

Your physiotherapy license includes a direct access provision, therefore you can treat customers without referral by a licensed provider. However, within three days of commencing treatment, you need to send in a Physiotherapist’s Initial Report (PTI) form detailing your initial findings. We will contact you if funding cannot be granted and will pay for services to the date of that advice. See PTI User Manual.

For soft tissue injuries, refer to the Primary Chiropractic and Physical Therapy Soft Tissue Treatment Guidelines.

If the injured worker’s recovery does not progress, contact the worker’s primary care provider who can request advanced assessment and treatment, or expedited appointments, if required.

Return to work should generally be part of each worker’s treatment plan. For more information, see our Recovery and Return to Work brochure.

Under provincial legislation, care providers do not require a signed release from an injured worker in order to provide medical information to the WCB. Early and regular care provider reports are important to the worker and us because:

  • We require customer medical records to process claims and appeals.
  • We may need to provide copies of reports to other health care providers, such as 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.

Use the following forms to provide information about treatment, functional recovery, and response to treatment. Please fill out reports completely and legibly and fax them to us as quickly as possible. We cannot pay for illegible or incomplete reports.

Only the customer’s FOM score should be submitted to the WCB, not the form itself. The score is to be reported on the Physiotherapist’s Initial Report below.

  • Physiotherapist’s Initial Report
    You are required to submit a Physiotherapist’s Initial Report (PTI), including the appropriate FOM score, 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 PTI 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. See PTI User Manual.
  • Progress and Discharge Reports
    A Physiotherapist’s Progress/Discharge Report (PTP), including the appropriate FOM score, should be completed after each block of 10 treatments unless the worker has been discharged, in which case, the PTP should be completed within 7 days. See PTP User Manual.
  • Return to Work Report
    Once a return-to-work plan has been agreed upon, the physiotherapist will submit a Practitioner’s Return to Work Report (PRTW) to us with copies to the primary care provider, the employer and worker to confirm the hours of worker and restrictions.
  • Other Reports
    Copies of special reports – diagnostic, operative, and so on – should always be forwarded to us. They provide us with relevant information, and save the attending practitioner from preparing a separate report.

Reporting Schedule – Physiotherapists report after every 10 treatment using the forms listed above. Failure to report can seriously delay an injured worker’s claims process and may result in delays or non-payment to the provider.

Reporting fees are paid by us when the care provider invoices the appropriate fee. If more than one report is received in the same day, only one report fee is paid.

There is a two-tier fee for PTI and PTP reports: one for reports that include FOM scores and a lower fee for those that do not include the scores.

Please bill us directly for services provided. To direct bill, you require a WCB billing number, which will be issued to you once your accreditation application has been approved. We will not pay for treatment provided prior to your accreditation date or for treatment provided at a clinic for which you have not been accredited.

You are responsible for confirming in advance that we will fund treatment for a customer according to the standards of care for your profession. Do not rely on the customer for this information because they may confuse their receipt of a claim number with a commitment by the WCB to pay for their treatment.

To expedite payment for services:

  • Retain your daily record of the services you provide to our customers in case an audit is required.
  • Summarize all services provided during the billing period using the Physiotherapist’s Billing (PHYS) form. Provide all information requested: the appropriate billing period, fee codes and caregiver number, and so on. Please note: We cannot process incomplete invoices. They will be returned unpaid for resubmission.
  • Follow the fee schedule agreed to by your professional association.
  • Forward the completed PHYS form to the WCB. See sample.
  • Use the PHYS form to make adjustments to previous billing periods. See sample.
  • Submit a Direct Deposit Application to receive your payments by electronic transfer.

We issue payment to caregivers weekly and provides vouchers to confirm that the payments that were issued. These vouchers may include explanatory codes to provide detail regarding specific services.

When an injury claim has been disallowed or benefits terminated, physical therapists will be notified that we cannot pay for further assessment or treatment. We will only pay for treatment for which authorization was given to date of notice of termination. We will also pay reporting fees to date of notice.

Online Business Transactions
You are encouraged to register for a secure @WCB Online Services account, which will allow you to view medical documents and your cheque history.