Medical Services Flashcards
Which types of medical providers can be AP
Type A
Med Doctors, Doctor of Osteopathic Med, Oral and
Maxillofacial surgeons, Podiatric physicians and
surgeons
Type B
Chiropractors, naturopathic physicians and physician assistants (PA)
*** Nurse Practitioner can be used as an AP even though not listed
How many days of TL or office visits can a Type B provide for medical services
Medical Services - 60 days or 18 visits from first visit or date on initial claim
Time Loss (TL) - 30 days from date of office visit on initial claim
Which Type B provider can also rate impairment
Chiropractors
Can an ER Dr. authorize TL? For how long?
Yes, for up to 14 days from ER visit
Time period for medical provider to submit the 827 form to the insurer when initiating a claim for workers’ comp benefits
72 hours from office visit
Time period to notify insurer of change of Attending Physician (AP)
5 days from first treatment of new AP
How many days does insurer have to respond to a written request for diagnostic preauthorization
Within 14 days of receiving request from provider
How many days does a medical provider have to send medical records to the insurer
Within 14 days of request from insurer
How many days can a ANP provide medical services and/or authorize TL benefits
180 days from initial claim
How many AP can an IW have during the life of a claim
3
How many days do insurers have to pay medical bills on an accepted claim
45 from receipt of bill
How many days do insurers have to pay medical bills which were prior to the claim being accepted
14 days from acceptance
How many days do insurers have to pay worker reimbursements
30 days from receipt
What can a worker request for reimbursement
Meals
Lodging
use of public transportation
use of private vehicle
Prescriptions
Other out of pocket, claim related expenses
Time frame to request reimbursement
Two years from date of claim or when determined to be compensable
