Physicians

Physicians are automatically authorized to treat WCB customers and to bill the WCB directly for their services.

Physicians accredited with Saskatchewan Health are authorized to treat WCB customers. Authorization is only required for procedures that are not funded by Saskatchewan Health.

As primary care providers, physicians may refer WCB customers to other care providers. Referrals must identify the medical limitations and goals and objectives of treatment.

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.

Doctor’s Billing (DOC) form

Physicians invoice the WCB for services provided to WCB customers using the Doctor’s Billing (DOC) form, or reasonable facsimile, following the Saskatchewan Medical Services Branch (MSB) payment schedule and assessment rules.

Payments for non-MSB insured services and reporting fees are established by the WCB in negotiation with professional associations representing physicians, chiropractors and physiotherapists, and so on. Non-MSB service fees are included in the fee schedule.

Because the WCB and MSB do not have a reciprocal billing process, invoices sent incorrectly to either insurer will be returned for resubmission.

To bill the WCB:

• List all services and service dates on the Doctor’s Billing (DOC) form.
• For non-MSB services, follow the fee schedule agreed to by your professional association.
• For MSB services, follow the MSB fee schedule.

Payment can only be issued if the invoice meets the 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
• physician’s name
• physician’s address
• physician’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 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 has been disallowed or benefits terminated, physicians will be notified that the WCB cannot pay for further assessment or treatment. We will only pay for treatment to date of termination. We will pay for fees submitted prior to the date of notification of disallowance.

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 vouchers 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.

Forms

Primary practitioners are required to submit a Primary Practitioner’s Initial Report (PPI) for all work-related injuries, including those that do not result in time off work. Where the worker loses time from work because of an injury, the PPI provides confirmation of disability, which allows the WCB to arrange timely payment of benefits to workers.

Copies of special reports – diagnostic, operative, and so on – should always be forwarded to the WCB. They provide us with relevant information, and save the attending practitioner from preparing a separate report.

Reporting fees are paid by the WCB when the physician invoices the appropriate fee. If more than one report is received on the same day, only one report fee is paid. We will not pay for:

• illegible reports
• incomplete reports
• photocopies of operative and diagnostic reports

A Physician’s Progress Report (PPP) should be completed whenever the worker’s condition, diagnosis or treatment changes, or when there is a need for a medical review. If the worker has not yet returned to work, then a review and report should be completed approximately every three weeks.

Support Package for Physicians & Nurse Practitioners Treating Workers

If a worker’s recovery does not progress, contact the WCB to request advanced assessment and treatment, or expedited appointments, if required.

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

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, physicians will:

• Comply with all requirements of the College of Physicians and Surgeons and Saskatchewan Health Medical Services Branch (MSB).
• Refer to the Support Package for Physicians & Nurse Practitioners Treating Workers.
• Bill the WCB in accordance with the fee schedule, as agreed to by the Saskatchewan Medical Association (SMA).
• 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.

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 physician, 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.

In 2016, the chief medical officers of the Workers’ Compensation Boards of Canada reviewed a number of studies pertaining to mild traumatic brain injury (mTBI/concussion) in an effort to give workers the most current evidence-based treatment and to ensure these injuries are managed according to best practices for adult occupational concussion/mTBI.

Having received an excellent summation of the studies from Dr. Edvin Koshi (MD, FRCPC, FIPP, FAADEP, CEDIR, CIME, CFE, Rehabilitation medicine (physiatry), fellow in pain medicine) the Saskatchewan WCB utilizes that information to ensure that WCB’s customer care facilitator staff, assessment teams and treatment centres apply the studies consistently and to provide a consistent return-to-work approach.

This 2016 educational presentation identifies some of the pitfalls in recognizing and managing adult mTBI, including diagnosis, prognosis and treatment.

View the presentation: Concussion (mild Traumatic Brain Injury)