What does Not Applicable (N/A) mean?
What is a Derived Fee (DF)?
What fees apply to medical reports requested by a worker's representative?
Who can apply to become a contracted Independent Medical Examiner (IME)?
Can we bill for telephone calls?
How do we bill for a meeting between a doctor and an investigator?
What does Not Applicable (N/A) mean?
Not Applicable (N/A) is found within various sections of the fee schedule. It relates to services not usually required in the workers compensation environment, for example, obstetrics. Where a medical practitioner considers these services to be necessary and appropriate, contact the claims agent or exempt employer to discuss payment.
What is a Derived Fee (DF)?
In this case a fee needs to be calculated. WorkCover has developed a formula for home and hospital visits. In all other cases the Medicare Benefits Schedule (MBS) rules apply.
What fees apply to medical reports requested by a worker's representative?
The regulated fee for a medical report applies.
Who can apply to become a Contracted Independent Medical Examiner (IME)?
Specialists and consultant physicians may apply to be contracted with WorkCover to provide IME services. A separate fee schedule applies for contracted providers where requests for independent medical examinations or reports are specifically made by the claims agent and self-managed employers. Reports requested by the worker or worker’s representative (for example, a solicitor) are paid at the regulated rate found in Schedule B.
Exempt employers may choose to pay according to the contracted fees, but can enforce the regulated fees if they choose. Please discuss payment with exempt employers prior to providing the report.
Can we bill for telephone calls?
Phone calls can be billed when the call is case-specific: made to, or received from the claims agent, employers, medical consultants or approved providers of return to work services. Telephone queries regarding accounts are not payable under these item numbers.
How do we bill for a meeting between a doctor and an investigator?
Use the third party consultation item number and fee found in Schedule B.