Chiropractors

Chiropractors are automatically accredited with the WCB through the Saskatchewan Medical Services Branch (MSB). Once in place, chiropractors use their MSB billing number to bill the WCB for services to workers.

Your chiropractic license includes a direct access provision, which means you can treat customers without referral by another licensed provider.

However, within three days of beginning treatment, you need to forward a Chiropractor’s Initial Report (CHI) form to the WCB detailing your initial findings. This form is required for the WCB to confirm funding of chiropractic care. Reoccurrences require WCB’s authorization to treat – see Practice Standards for Primary Level Chiropractic Service Providers.

If the patient’s claim is later denied or benefits terminated, we will notify you that we cannot pay for further assessment or treatment. We will pay for the intake assessment, the initial report and any treatment given up to the date of the termination notice. We will also pay reporting fees to the date of notice.

Until we let you know if a patient’s claim is denied or benefits terminated, Medical Services Branch, other insurers, and/or the worker shall not be billed for any treatment or portion of treatment.

Chiropractor’s Billing Form (CHRO)

The schedule of payments for services and reporting fees are established by the WCB in negotiation with the Chiropractors Association of Saskatchewan.

Payment can only be issued if the invoice meets our criteria. The following information is required:

• worker’s name
• worker’s address
• Provincial Health Number (PHN)
• date of birth
• date(s) of service
• care provider number
• clinic number
• chiropractor’s name
• chiropractor’s address
• chiropractor’s phone and fax number
• fee code(s)
• fee code amount(s)
• number of units

Follow the fee schedule agreed to by your professional association. Review the complex case criteria to determine which injuries are considered complex and would require more intensive and frequent management by a practitioner.

Keep a daily record of the service you provide to our customers in case an audit is required.

If the WCB receives an application for payment after a 12-month period from the time the medical aid is provided to a worker, the WCB will not pay any account rendered by a physician, surgeon, hospital or other health care professional or institution. See WCB Procedure, Medical Aid Billings – Payment (PRO 53/2006).

By submitting WCB invoices online, they will be processed through an automatic payment process.  This means your invoices will be paid sooner than if you fax or email them to us.

Online submission methods:

1. Single submission:  Submit an individual invoice related to a worker.
2. Batch submission: If you use Accuro/QHR Technologies or CBS Navicert software to keep track of your medical records, you can submit a batch of invoices to the WCB online. As long as you have the access to submit invoices online, you can submit all invoices from any time period and from any care provider at the same time.

You will need a WCB online account to submit invoices online.  Sign into your WCB online account or, if you don’t have one, create a WCB online account here.

Save time and give your users the ability to upload invoices online.

Eliminate entry duplication by uploading invoices from your system to the WCB website. Here is the document with instructions on how to update your software: Everything a vendor needs to know.

Here are the files needed for updating your system to be compatible with the medical invoice batch submission process:

1.    eBillBatchInvoice.xsd
2.    ebillBatchInvoiceReturn.xsd
3.    Batch Submission – Error Codes.xlsx

If you have any questions with the batch submission process or are ready to test your system with us, please contact the webmaster.

Vendors who are already capable of uploading batch invoices:

Accuro/QHR Techologies	CBS Navicert Software

You are encouraged to register for a secure WCB online account, which allows you to view medical documents and your cheque history.

The WCB issues payment to care providers weekly and provides statements to confirm the payments were issued. These statements may include explanatory codes to provide details regarding specific services.

Submit a direct deposit application to avoid delays in your WCB payments by receiving your payments by electronic transfer. Register for direct deposit.

Care providers, like employers and workers, are required to report to the WCB any injury that requires medical attention, whether or not the worker needs time off work beyond the day of the injury. Prompt reporting allows the WCB to arrange timely payment of benefits to workers.

Legislative obligations

Under legislation, care providers do not require a signed release from a worker in order to provide medical information to the WCB because:

• WCB staff need customers’ medical records to process claims and appeals.
• The WCB may need to provide copies of reports to other care providers, such as assessment teams, treatment centres and specialists, to assist in obtaining the best possible assessments and treatments for workers.
• In the case of an appeal, a worker’s records may be made available to an employer or others, but only with the worker’s approval.

Forms

Use the following forms to provide information about treatment, functional recovery, and response to treatment. Please fill out reports completely and legibly and fax them to WCB as quickly as possible. The WCB cannot pay for illegible or incomplete reports.

• Functional Outcome Measures (FOM)
  Administer the appropriate Functional Outcome Measures self-report tests to WCB customers as soon as possible to help identify those who may be at risk for prolonged recovery and who would benefit from more intensive treatment. These tests include:
  • Lower Extremity Functional Scale (LEFS)
  • Neck Disability Index (NDI)
  • Quick Dash and Work Module for upper extremities
  • Roland Morris for backs

Only the customer’s FOM score should be submitted to the WCB, not the form itself. The score is to be reported on the Chiropractor’s Initial Report.

• Chiropractor’s Initial Report
  You are required to submit a Chiropractor’s Initial Report (CHI), including the appropriate FOM score, for all injuries, including those that do not result in time off work. Where the worker loses time from work because of an injury, the CHI provides confirmation of disability, which allows the WCB to arrange timely payment of benefits to workers. Prompt reporting is important. See CHI User Manual.
• Chiropractor’s Progress/Discharge Report
  A Chiropractor’s Progress/Discharge Report (CHP), including the appropriate FOM score, should be completed after each block of six treatments unless the worker has been discharged, in which case, the CHP should be completed within seven days. See CHP User Manual.
• Practitioner’s Return-to-Work Report
  Once a return-to-work plan has been agreed upon, the chiropractor will submit a Practitioner’s Return-to-Work Report (PRTW) to the WCB with copies to the primary care provider, the employer and worker to confirm the hours of work and restrictions. See PRTW user manual.
• Other reports
  Copies of special reports – diagnostic, operative, and so on – should always be forwarded to the WCB. They provide the WCB with relevant information, and save the attending practitioner from preparing a separate report.

There is a two-tier fee for CHI and CHP reports: one for reports that include FOM scores and a lower fee for those that do not include the scores.

Reporting fees

Reporting fees are paid by the WCB where the care provider invoices the appropriate fee. If more than one report is received in the same day, only one report fee is paid. The WCB will not pay for illegible or incomplete reports.

View reports (WCB’s secure online site)

The WCB has a “View client information” application available for primary level chiropractors and physical therapists to use through their WCB online account. This application provides you with the ability to easily view medical documents online for a worker that you are treating. As soon as a new report comes in for your claim, you will automatically be able to view it.

The “View client information” application will allow you to see medical reports from other care providers, as well as referrals the WCB is making to specialists, diagnostics, assessment teams, etc. Assessment team reports do not appear on the “View client information” application as the assessment team will send a copy of the summary report to all current providers and a copy of the complete report to the primary care provider and surgeon.

You must have a WCB online account to view medical documents online for workers you are treating. You must have an online report submitted before the “View client information” application will be available to you. You also must complete online reporting regularly to use “View client information.”

Support Package for Chiropractors and Physical Therapists

Return to work and active lifestyle should generally be part of each worker’s treatment plan. For more information, see our recovery and return to work page.

If the worker’s recovery does not progress, you may ask for expedited appointments or assessment team review  using the Chiropractors’ Initial Report (CHI).

For soft tissue injuries, refer to the Primary Chiropractic and Physical Therapy Soft Tissue Treatment Guidelines.

When acting as the primary care provider, chiropractors may refer WCB customers to other care providers. Referrals must identify the medical limitations and goals and objectives of treatment.

Please note: Referrals do not constitute authorization to treat. If you refer WCB customers to non-physician providers, the providers must contact the WCB for authorization to treat the referred customers on a file-by-file basis.

When treating WCB customers, care providers assume certain roles and responsibilities. The WCB relies on all care providers to ensure that:

• All work-related injuries requiring medical aid are reported promptly.
• All treatment is necessary and consistent with established agreements.
• All invoices accurately reflect the services provided.
• The employer and worker are aware of current restrictions to allow early return to work.

When treating WCB customers, chiropractors will:

• Know and follow all requirements of the Chiropractors’ Association of Saskatchewan (CAS) and the WCB’s Practice Standards for Primary Level Chiropractic Service Providers document.
• Refer to the Support Package for Chiropractors/Physical Therapists.
• Bill the WCB in accordance with the WCB fee schedule as agreed to by the CAS.
• Show ethical practice standards on a day-to-day basis. This includes informing any prospective WCB customer of business relationships you may have with their employer, so the worker can decide whether they want to choose you as a care provider.
• Avoid mentioning in either your clinic’s advertisements or personal advertisements that you treat WCB customers or you are affiliated with the WCB in any way.

Learn about when a Medical Review Panel can be considered and the information that is required from the worker and the worker’s physician.

If you are a chiropractor, learn more about what your responsibilities are when completing an enabling certificate for a Medical Review Panel.

If you are a member of a Medical Review Panel, these are your responsibilities.

Chiropractors Association of Saskatchewan