WCCA 12 – Medical Benefits in California Workers’ Comp Claims




WCCA 12 - How It Benefits You

You’ll learn to confidently recognize and comply with the laws that
govern payment of medical expenses and independent bill review.

You will set yourself apart as a knowledge resource in your organization with
enhanced understanding of medical control issues.

You’ll be able to competently handle complex claims involving utilization review
and independent medical review.

Take this course if you are:

A workers’ compensation claims adjuster.
Employed by a TPA or Self-Insured entity
A medical only claims adjuster

Key Takeaways:

The scope of medical treatment provided under workers’ compensation.
Authorized physician and the role of the primary treating physician
Utilization Review (UR) and the Independent Medical Review (IMR) procedures
How to use the medical treatment utilization schedule .
How to develop a UR plan in accordance with law and regulation.
When and why IMR is used and how to appeal or implement determinations

Other Topics You'll Learn

Medical Provider Networks .
Laws/regulations on payment of medical expenses and Independent Bill Review.
Law governing medical provider’s submission and the employer’s response
IBR rules and  requirements, steps and standards underlying the process
Complex liens and lien management

Course Credit Hours
Course CE Credit
CPWC – 12 Hours
CCMP – 12 Hours
CA-WC-CERT – 25 Hours
CPDM – 12 Hours
MCLE – 25 Hours recommended -individual submission required to State Bar Association for credit.

Required Materials
WCCA 12 Books & Exams.

Exam Information
FINAL EXAM (Proctor REQUIRED) must be ordered from The Institutes if you are pursuing a designation.


Thanks for stopping by. Interested in taking WCCA12? Next session starts February 2022. Check back in a few days for full details or call (800) 655-4432.