Effective date: June 1, 2015
Application: All claims on and after the effective date.
Policy subject: Health care services – Providers
To provide administrative guidelines for approving and evaluating massage therapy services.
- Upon Workers’ Compensation Board (WCB) approval, a worker entitled to benefits under The Workers’ Compensation Act, 2013 (the “Act”) is also entitled to (Section 103):
- Any medical aid that may be necessary because of the work-related injury.
- Any other treatment by a health care provider.
- Any prosthetic or apparatus that may be necessary as a result of the injury, and
- Any travel and sustenance costs associated with receiving medical treatment as a result of the injury.
- The WCB is authorized to determine health care services fees (Section 104).
- The practice standards, accreditation requirements, fees, reporting forms and primary authorization to treat forms for massage therapists (MT) providing services to WCB customers are available at www.wcbsask.com. The Massage Therapy Association of Saskatchewan (MTAS) and the WCB will negotiate changes to these documents as needed.
- The Claims Entitlement Specialist (CES) or Case Manager (CM) will review completed Primary Authorization to Treat forms with attached referrals to make sure:
- The service relates to the work injury.
- The MT and massage therapy clinic have WCB accreditation.
- The referral is made by a:
- Physical Therapist, or
- The referral notes the goals of massage therapy.
- The worker is currently receiving active therapy (e.g., exercise therapy) from a:
- Physical therapist, or
- The CES or CM will tell the MT in writing if they are authorized to provide care and invoice the WCB. If the MT is authorized, the CES or CM will also tell the MT:
- The WCB will only pay for up to five massage therapy treatments per claim.
- To direct bill the WCB.
- If an initial assessment, progress and/or discharge reports will be funded.
- The WCB will not pay for any services provided before the MT receives approval.
- The WCB will stop paying for massage therapy when the worker:
- Is not making any functional gains
- Has met the goals of massage therapy, or
- Receives five massage therapy treatments.
- Medical and Health Care Services (MHCS) will perform ad hoc file reviews to ensure quality assurance.
- MHCS will run monthly reports to track and evaluate quantitative variances and trends.
- MHCS and the MTAS will monitor compliance with the:
- Service fees.
- Practice standards.
- MHCS will issue letters to MTs that do not comply with the service fees or standards. These letters will outline appropriate corrective actions. Failure to comply with these actions may result in the loss of WCB accreditation.
Complaints and Dispute Resolution
- Workers can report complaints of any nature to the WCB. The WCB employee receiving the complaint may refer the complaint for resolution to other WCB staff including the Manager of Health Care Services. If the complaint alleges professional incompetence or misconduct by a care provider, the Manager of Health Care Services will direct the complaint to the MTAS.
- MCHS will note all complaints and resolutions on the service provider’s accreditation file.
- Workers that want to see a different provider should discuss concerns with the primary care provider who made the initial referral.
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