Nurse practitioners 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 WCB 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.
Your nurse practitioner license includes a direct access provision. This means you can treat our customers without referral by a licensed provider. However, within three days of beginning treatment, you need to send in a Primary Practitioner’s Initial Report (PPI) form detailing your initial findings. We will contact you if funding cannot be granted and will pay for services to the date of that treatment.
You may refer our customers to other care providers. Referrals must identify the medical limitations and goals and objectives of treatment. Please note that referrals do not constitute authorization to treat. The providers must contact us for authorization to treat the referred customers on a file-by-file basis.
To prevent financial hardship to a WCB customer, bill the WCB directly for approved services. To direct bill, you require a WCB billing number, which you received when your accreditation application was approved. The WCB 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.
Invoice us for services provided to our 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 us in negotiation with professional associations. Non-MSB service fees are included in the fee schedule.
We do not have a reciprocal billing process with MSB. Invoices sent incorrectly to either insurer will be returned for resubmission.
List all services and service dates on the Doctor’s Billing (DOC) form.
Follow the fee schedule agreed to by your professional association and the WCB.
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 a 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|
We will notify you when an injury claim is disallowed or benefits are terminated. If we deny a worker’s claim after you provide services, we will only pay for non-Saskatchewan Medical Services Branch (MSB) fees submitted prior to the date of notification of disallowance. We will not pay MSB and treatment fees.
We issue payments to care providers weekly and provide statements to confirm the payments were issued. These statements may include explanatory codes to provide details regarding specific services.
Submit a direct deposit application to avoid delays in your WCB payments by receiving your payments by electronic transfer.
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:
Nurse practitioners 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.
Nurse practitioners report after every three weeks or earlier if the worker’s condition changes using the forms listed above. Failure to report can seriously delay our customer’s claims process and may result in delays or non-payment to the provider.
Reporting fees are paid by us when invoices use the appropriate fee. If more than one report is received in the same day, only one report fee is paid.
When treating WCB customers, care providers assume certain roles and responsibilities. The WCB relies on all care providers to ensure that:
When treating our customers, nurse practitioners will:
For more information, please refer to our Support Package for Physicians & Nurse Practitioners.
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