By discipline: Physicians
Studies pertaining to mTBI
The Chief Medical Officers of the Workers’ Compensation Boards of Canada have recently reviewed a number of studies pertaining to mild traumatic brain injury (mTBI/Concussion) in an effort to afford inured workers the most current evidence based treatment and to ensure that these injuries are managed according to best practice for adult occupational concussion/mTBI.
Having received an excellent summation of the studies from Dr. Koshi, the Sask. WCB plans to utilize that information to ensure that WCB’s case management staff, assessment teams and treatment centres apply the studies consistently.
This excellent educational presentation identifies some of the pitfalls in recognizing and managing adult mTBI including diagnosis,prognosis and treatment.
I hope these are useful to you and that the WCB can move forward in step with yourselves to provide a consistent successful treatment and return to work approach.
MD, FRCPC, FIPP, FAADEP, CEDIR, CIME, CFE
Rehabilitation Medicine (Physiatry)
Fellow in Pain Medicine
Physicians are automatically authorized to treat WCB customers and to bill the WCB directly for their services.
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; and
- all invoices are appropriate.
When treating WCB customers, health care providers assume certain roles and responsibilities.
In treating WCB customers, 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 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 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.
Physicians accredited with Saskatchewan Health are authorized to treat WCB customers. Authorization is only required for procedures that are not funded by Saskatchewan Health.
As primary care providers, physicians may refer WCB customers 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 customers to non-physician providers, the providers must contact us for authorization to treat the referred customers on a file-by-file basis.
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 us to arrange timely payment of benefits to injured workers.
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.
A Physician’s Progress Report (PPP) should be completed every three weeks or if the customer’s condition changes. If the worker has been discharged, the PPP should be completed within three days.
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 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. We will not pay for illegible or incomplete reports.
- Physicians invoice us for services provided to WCB customers 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, and so on. Non-MSB service fees are included in the 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 us. If you prefer to use a different format, make sure to include all the information requested; and
- Submit a Direct Deposit Application to receive your payments by electronic transfer.
When an injury claim has been disallowed or benefits terminated, physicians will be notified that we cannot pay for further assessment or treatment. We will only pay for treatment to date of notice of termination. We will also pay reporting fees to date of notice.
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.