Medical Benefits in Workers' Compensation Claims

Overview

• What you'll learn
  • The scope of medical treatment provided under workers’ compensation
  • Authorized physician and the role of the primary treating physician
  • Utilization Review (UR) and 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

  • 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
• Who Should Attend
  • A workers’ compensation claims adjuster
  • Working with a TPA/Self-Insured entity
  • Involved with Medical Only claims adjusting
• Tools & and Course Materials
  How to locate your Books and Exams
  1. Click here.
  2. Scroll to “WCCA 12: Medical Benefits in CA Workers’ Compensation Claims”.
  3. Select “WCCA 12 Recommended Materials Package. 2nd edition”.*NOTE: Texts and exams for this course must be purchased directly from The Institutes.

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

Medical Benefits in Workers' Compensation Claims

• 10 weeks
• 1 hour lessons
• Online dashboard for quizzes

• Instructor-led $479
  June 19, 2023 -
  August 28, 2023 11:30am - 12:30pm No class July 3rd Carmen Angeles