Hearing service providers

Before you can provide audiology services to WCB customers and bill the WCB directly for those services, you must be accredited by the WCB.

To apply for accreditation with the WCB:

1. Read the Practice Standards for Audiologists Providing Services to WCB Customers carefully.
2. Complete, print and sign the Accreditation Request form.
3. Attach copies of documents proving that you are either:

• • An audiologist currently licensed and in good standing with the College of Speech-Language Pathologists and Audiologists of Saskatchewan (CSASK).
  • A hearing instrument practitioner currently registered and in good standing with the Saskatchewan Hearing Instrument Practitioners Society (SHIPS).
  • A graduate of a minimum two-year program at an accredited university or technical school with a directly supervised practicum of 840 hours.

• Also, include copies of the following documents with your form:
  • The degree, diploma, etc. that the educational institute you attended issued to you.
  • Your current and valid license issued to you following the guidelines in The Hearing Aid Sales and Services Regulations.

4. Fax your accreditation package to the WCB’s health care services department to the fax number on the form.

Make sure all documentation is included. Note: The WCB cannot process incomplete applications.

Our health care services department will review your application after receiving it. We will:

• Review your credentials against the requirements listed in the Practice Standards for Audiologists Providing Services to WCB Customers.
• Add your name to our approved providers list, if you are eligible.
• Notify you by mail that your accreditation request has been accepted or denied.
• Mail your WCB billing number to you.
   

Accreditation is non-transferable

You can only bill for services from all the clinics you listed on your application. If you want to add a clinic to your portfolio or if a clinic changes location, you must submit a separate accreditation request for that clinic before you begin treating customers there. We cannot issue payment for care at a clinic where the provider is not accredited prior to that care being provided.

You must get approval from the WCB to treat WCB customers. Don’t rely on customers for authorization because they may think their claim number means the WCB has agreed to pay for their treatment.

To get approval, complete the Hearing loss – Request for funding (MCARE) form and either mail or fax it to the WCB. If you don’t get approval before treating, we may not pay for your services.

Note: If the patient’s claim is later denied after you received approval, we will notify you and pay for treatment that we approved up to the date of the termination notice. We will also pay reporting fees to the date of notice.

Audiology’s Billing (AUD) form

To prevent financial hardship to a WCB customer, bill the WCB directly for approved services and appliances. You can only bill workers for the difference in costs if they want a more expensive model than the one approved for them by the WCB.

To direct bill, you will need the WCB billing number you or your clinic received when your accreditation application was approved. The WCB will not pay for services or appliances provided before your accreditation date or provided at a clinic where you have not been accredited.

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
• hearing service provider’s name
• hearing service provider’s address
• hearing service provider’s phone and fax number
• fee code(s)
• fee code amount(s)
• number of units

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).

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

Bill costs should match the fee schedule for hearing service providers.

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 WCB online account, which allows you to view past and present payment statements.

The WCB issues payments 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 work-related 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.

Please review the WCB’s hearing loss fact sheet for guidelines to establish traumatic and occupational noise-induced hearing loss claims.

To establish hearing loss, submit a Primary Level Authorization to Treat – Hearing Services form to the customer’s case manager, along with:

• The customer’s audiogram.
• Your recommendation for an entry-level hearing aid. If the customer needs a mid-range or premium product, you must provide medical justification of why this is required.

Once WCB operations staff have confirmed and approved the claim, you can provide the customer with the hearing aid. The WCB will only cover the cost of an approved entry-level or basic hearing aid, except where a worker has a medical need for another aid. If workers want a more expensive model than the one the WCB approved, you can directly bill the worker for the difference in costs.

You will still need to submit a Primary Level Authorization to Treat – Hearing Services form for other services you may provide the customer, including repairs to their hearing aids. For each new fitting, you need to conduct at least one follow-up visit with the customer, with a maximum of two visits per year.

You do not need to submit the form before providing new batteries to customers who have hearing aids funded by the WCB.

When treating WCB customers, health care providers assume certain roles and responsibilities. The WCB relies on all health 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, hearing service providers will:

• Know the guidelines listed in Practice Standards for Audiologists Providing Services to Saskatchewan WCB Customers, as well as WCB billing and reporting requirements.
• Get approval before treating WCB customers on a file-by-file basis.
• Follow the practice standards and fee schedule created for hearing service providers.
• Demonstrate 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 your or your clinic’s advertisements that you treat WCB customers or you are affiliated with the WCB in any way.

To ensure that the Practice Standards for Audiologists Providing Services to Saskatchewan WCB Customers is being followed, the WCB may conduct compliance surveys. You will receive a notice from WCB two weeks before you, your clinic, or your treatment centre receives its compliance survey.