When using the Workers Compensation Board (WCB) Medical Fee Schedule to bill, are health providers bound by the preauthorization requirements contained in the fee schedule?
• Ans: No. Regulation No. 83, Section 68.1(b)(1) states that the general instructions and ground rules in the WCB Medical Fee Schedule applies to No-Fault claims, however those ground rules which refer to workers’ compensation claim forms, pre-authorization approval and dispute resolution guidelines do not apply to No-Fault. • I accepted a No-Fault assignment from a patient and rendered treatment. When I submitted the bill to the No-Fault insurer, they issued a denial of claim based on the results of an insurer medical examination (IME). Can I pursue the patient directly for payment of this bill? • Ans: No. A physician who has accepted a No-Fault assignment of benefits from a No-Fault patient may not pursue the patient directly for payment if the No-Fault carrier denies payment for services based upon a determination that the services were not medically necessary. Such action by the provider would not be permitted under the No-Fault assignment of benefits language contained in claim fo
Related Questions
- When using the Workers Compensation Board (WCB) Medical Fee Schedule to bill, are health providers bound by the preauthorization requirements contained in the fee schedule?
- Since Florida Workers Compensation allows payment above the fee schedule, can judges discount a doctors testimony if he was paid above the fee schedule?
- How can I find another states workers compensation fee schedule?
