Massage therapists must apply for accreditation with the WCB. Learn about accreditation, authorization to treat, billing, payments, reporting to the WCB and what forms you need.
Before you can provide services to customers and bill the WCB directly for those services, you must be accredited by the WCB.
To apply for accreditation with the WCB:
Make sure all documentation is included. Note: The WCB cannot process incomplete applications.
Our health care services department will review your application after receiving it. We will:
You can only bill for services from all the clinics you listed on your application. If you want to add a clinic to your portfolio or if a clinic changes location, you must submit a separate accreditation request for that clinic before you begin treating customers there. We cannot issue payment for care at a clinic where the provider is not accredited prior to that care being provided.
You must get approval from the WCB to treat WCB customers. Don’t rely on customers for authorization because they may think their claim number means the WCB has agreed to pay for their treatment.
First, the injured worker’s primary care provider (physician, chiropractor, or physical therapist) must provide a written referral to include massage therapy treatment. The referral will identify the goals and objectives for massage therapy.
Next, massage therapists must include this referral, along with a completed Primary Authorization to Treat form to the customer’s WCB representative before any treatment begins. If treatment is approved, the WCB representative will sign the form and fax it back to the massage therapist.
Note: If you don’t receive approval before treatment, any services you provide may not be paid for by the WCB.
To prevent financial hardship to a WCB customer, bill the WCB directly for approved services. Do not bill the worker, employer or other insurance plans for amounts in excess of the massage therapist fee schedule. (Note: The WCB will not pay for treatment given before your accreditation date or for treatment provided at a clinic not listed on your accreditation form.)
If a claim is later denied following approval for treatment, the WCB will only pay for approved treatment given to date of notice of termination.
Payment can only be issued if the invoice meets our criteria. The following information is required:
If the WCB receives an application for payment after a 12-month period from the time the medical aid is provided to an injured worker, the WCB will not pay any account rendered by a physician, surgeon, hospital or other health care professional or institution. See WCB procedure, Medical Aid Billings – Payment (PRO 53/2006).
Keep your daily record of the service you provide to our customers in case an audit is required.
By submitting WCB invoices online, they will be processed through an automatic payment process. This means your invoices will be paid sooner than if you fax or email them to us.
Online submission methods:
Save time and give your users the ability to upload invoices online.
Eliminate entry duplication by uploading invoices from your system to the WCB website. Here is the document with instructions on how to update your software: Everything a vendor needs to know.
Here are the files needed for updating your system to be compatible with the medical invoice batch submission process:
If you have any questions with the batch submission process or are ready to test your system with us, please contact the webmaster.
Vendors who are already capable of uploading batch invoices:
|Accuro/QHR Techologies||CBS Navicert Software|
The WCB issues payments to care providers weekly and provides statements to confirm the payments were issued. These statements may include explanatory codes to provide details regarding specific services.
Care providers, like employers and workers, are required to report to the WCB any work-related injury that requires medical attention, whether or not the worker needs time off work beyond the day of the injury. Prompt reporting allows the WCB to arrange timely payment of benefits to injured workers.
Under legislation, care providers do not require a signed release from an injured worker in order to provide medical information to the WCB because:
Massage therapists report to the WCB using the following TX coded forms that provide information about treatment, functional recovery, and response to treatment:
Massage therapists only need to submit these reports if the WCB requests them. Information about the worker’s functional ability may be given to the employer so a return-to-work plan can be created.
The WCB limits the number of massage therapy treatments to five sessions per claim. Payment for additional massage therapy treatments will not be reimbursed by the WCB.
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.
Returning to work should generally be part of each worker’s treatment plan. For more information, see our recovery and return to work page.
When treating WCB customers, care providers assume certain roles and responsibilities. The WCB relies on all care providers to ensure that:
When treating WCB customers, massage therapists will:
To ensure that Practice Standards for Massage Therapy Service Providers are being followed, the WCB may conduct compliance surveys. You will receive a notice from the WCB at least two weeks before you, your clinic, or your treatment centre receives its compliance survey so you can review the survey form and guidelines. It will take about 1.5 hours for you to complete the survey.
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