Optometrists

Optometrists are accredited with Saskatchewan Health and are, therefore, automatically accredited with the WCB and authorized to treat WCB customers.

Optometrists’ fees for services provided to WCB customers are based on the Saskatchewan Medical Services Branch (MSB) payment schedule and assessment rules. For WCB specific fees, use the WCB’s Physician’s Fee Schedule.

Summarize all services provided using the Doctor’s Billing (DOC) form or your own invoice form.

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
• optometrist’s name
• optometrist’s address
• optometrist’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 a daily record of the service you provide to our customers in case an audit is required.

If you need to update your address, please contact the Medical Services Branch (MSB).

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

When an injury claim is disallowed:

• Optometrists are reimbursed by the Saskatchewan Medical Services Branch (MSB) for treatment provided.
• The WCB pays all reporting fees to date of notification.

You are encouraged to register for a secure 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 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.

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, optometrists will:

• Comply with the Saskatchewan Health standards of care.
• Bill the WCB in accordance with the fee schedule established for your professional group.
• Demonstrate ethical practice standards on a day-to-day basis, including disclosure to any prospective WCB customer of any business relationship you may have with their employer. This allows the worker to make an informed decision regarding their choice of 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.