Document name
Psychologists
Document number
PRO 50/2017

Effective date: April 1, 2017

Application: All claims where workers require primary psychological care

Policy subject: Health care services – Providers

Purpose:

To provide administrative guidelines for approving and evaluating services provided by psychologists.

BACKGROUND

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  1. Upon Workers’ Compensation Board (WCB) approval, a worker entitled to benefits under The Workers’ Compensation Act, 2013 is also entitled to (Section 103):
    1. Any medical aid that may be necessary because of the work-related injury.
    2. Any other treatment by a health care provider.
    3. Any orthotic appliance or apparatus that may be necessary as a result of the injury, and
    4. Any travel and sustenance costs associated with receiving medical treatment as a result of the injury.
  2. The WCB is authorized to determine health care services fees (Section 104).

PROCEDURE

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General

  1. Psychologists who are fully licenced members in good standing of the Saskatchewan College of Psychologists (SCP), hold the Authorized Practice Endorsement (APE) and are accredited by the WCB to provide services to injured workers can access the following at www.wcbsask.com:
    1. Practice Guidelines for Psychologists Providing Primary Level Services and Assessment Services to WCB Customers.
    2. Accreditation requirements.
    3. Fees.
    4. Reporting forms.
    5. Primary Authorization to Treat forms.

Under the advice of the WCB Psychological Consultant, the WCB will update these documents as needed.

  1. Claims Entitlement Specialists (CES) will review Primary Level Authorization to Treat – Psychology/Counsellors forms, initial reports (PSYI) and progress/discharge reports (PSYP) that the WCB receives within the first four weeks post-injury. Case Managers (CM) will review reports that the WCB reviews after four weeks unless Claims Entitlement retains the file.
  2. CESs and CMs can request the assistance of the WCB Psychological Consultant at any time during the review of claims.
  3. If the CES, CM or WCB Psychological Consultant determines that the WCB should deny coverage, the file manager will inform the psychologist. The WCB will pay for services up to the date of notification.
  4. Psychologists treating workers automatically agree to participate in any quality assurance programs that the WCB develops.
  5. Medical and Health Care Services (MHCS) may send letters to psychologists that do not comply with the practice guidelines. Letters will outline appropriate corrective actions. Further non-compliance may result in the loss of WCB accreditation.
  6. MHCS may send letters to psychologists that do not comply with the WCB’s reporting requirements. Letters will note the WCB’s reporting requirements and outline appropriate corrective actions. Further non-compliance may lead to the WCB denying payment for treatment.
  7. 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 complainant to the SCP.
  8. MHCS will note all complaints and resolutions on the service provider’s accreditation file.
  9. Workers who want to see a different provider must discuss with their primary care provider who made the initial referral.

Policy references

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Section heading

Act Sec #

Section detail

55, 103, 104, 115(c)

Section heading

Supersedes

Section detail

PRO 51/2014  Medical Fees – Psychologists

Section heading

Complements

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