Reference Manual For WCB
Reference Manual For WCB
Reference Manual For WCB
Reference Manual
Department WorkSafeBC Health Care Services
Date January 2016
Craig Aspinall, Program Manager
Prepared by Kelly Kinghorn, Quality Assurance Supervisor
This manual is intended to assist with specific business processes related to doing business
with WorkSafeBC. This is not a stand-alone document and it is intended that this manual be
used in conjunction with the Massage Therapy Services Memorandum of Agreement, and all
the related Schedules, which were effective January 1, 2016.
Treatment Services
The goal of massage therapy for WorkSafeBC is to assist Injured Workers reach the
functional levels required to return to pre-injury work in a safe, durable, and timely manner.
This requires the Registered Massage Therapist to have an understanding of the Injured
Worker’s pre-injury work hours and duties. Return to work and massage therapy treatment
may occur concurrently.
The Massage Therapist should provide education to the Injured Worker regarding what they
can expect from the treatment, the concept of early re-activation, self management of their
injury, prevention of re-injury, and the benefits of increasing function and activity.
Authorization is typically not given for a worker to attend more than one type of treatment
in a given time period. The Injured Worker must choose between attending physiotherapy,
chiropractic or massage therapy. Massage therapy is typically not authorized when a worker
is attending a treatment program. Concurrent treatments may be considered only under
special circumstances and pre-approved by the Board Officer (a “Board Officer” is typically a
WorkSafeBC Case Manager, Entitlement Officer, Vocational Rehabilitation Consultant, RTW
Specialist or other as designated).
A referral from a physician must be received before a Registered Massage Therapist can
treat an Injured Worker. The referral must be kept in the clinical record.
There are two categories of treatment:
• Standard Treatment
• The Massage Therapist can provide 1 Initial Visit and up to 12 Subsequent
Treatments within the first 8 weeks after the date of injury.
• Board Officer approval is not required for any treatments that occur
within 8 weeks from the date of injury.
• Board Officer approval is required for any treatments that occur later
than 8 weeks after the date of injury.
• Treatment is limited to one massage visit per day.
If the status of the claim is pending, this means that a decision has not yet been made on
whether it will be an accepted claim. In this circumstance the provider may choose to bill
the worker privately. If the claim is subsequently accepted the provider must reimburse
100% for all Massage Therapy costs paid by the worker prior to the date the claim was
accepted and bill WorkSafeBC directly at contracted rates.
COMMUNICATION
General Communication
• The following are situations that require immediate disclosure to the appropriate
WorkSafeBC staff member:
• Any implicit or explicit threat towards a WorkSafeBC staff member or
property; and/or
• Any statement or action of harm directed towards another individual.
• Where any accident or critical incident occurs, the Board Officer and Attending
Physician must be notified immediately by telephone and a written incident
report must be submitted to WorkSafeBC.
• In situations where the incident results in the Injured Worker requiring
emergency care, the Contractor must contact the WorkSafeBC Health Care
Services Program Manager within one (1) business day.
• The Massage Therapist will promptly report to WorkSafeBC any injury to an
Injured Worker occurring during treatment.
• When reporting one of the above, the seriousness of intent should also be
communicated. Contact the Quality Assurance Supervisor If in doubt of the
appropriate person to contact.
• If an interpreter is required for any communication with an Injured Worker, please
contact the Board Officer or Service Coordinator associated with the claim for
assistance in arranging this.
Telephone Communication
• If the Massage Therapist is involved in communicating meaningful details on an
Injured Worker treatment, return to work plans, or other related issues then they
may invoice for this time using fee code 19158.
• Communication could be through a detailed message or could involve a conversation
with a Health Care Provider, a Board Officer, or an employer.
• This communication must be documented, and billing should not occur for routine,
administrative and or quality assurance issues.
INVOICES
• Invoices for services must be received within 90 days following the date of service.
Invoices received beyond 90 days will not be paid unless there are exceptional
circumstances to account for the delay in billing. For assistance with Program related
business process questions for invoicing, please contact Health Care Services at
WorkSafeBC at (604) 232-7787.
General
• It is the Massage Therapist’s responsibility to confirm the worker’s claim status.
• If the claim is pending at the initial visit, it is up to the Massage Therapy Provider as
to how payment is collected (i.e. directly from the Injured Worker or awaiting a
claim’s decision). Treatment provided during this pending time will not be paid by
WorkSafeBC if the claim is subsequently disallowed.
• When a pending status becomes accepted, the Massage Therapy Provider must
reimburse the worker 100% for all massage costs paid prior to the date the claim
was accepted, and invoice WorkSafeBC directly according to the fee amounts in
Schedule B of the Agreement.
• A Massage Therapist shall not invoice WorkSafeBC for missed, late, or cancelled
appointments under any circumstances.
• A Massage Therapist must not charge any additional fees to an Injured Worker who
has a claim accepted by WorkSafeBC (e.g. therabands, user fees, administrative
fees, ice pack, etc.).
This coding is mandatory on all invoices submitted via MSP Teleplan. It allows for expedited
matching of invoices to claims, resulting in timely payment.
Codes can be accessed on line at: http://www.worksafebc.com under health care providers
– health care practitioners – massage therapists.
• A “Massage Treatment Report” is required within 5 business days of the initial visit,
when requesting an extension for regular Treatment beyond eight (8) weeks of the
Injured Worker’s date of injury, for Extenuating Medical Circumstances treatment
beyond six (6) months, or as requested by WorkSafeBC.
• If requested by WorkSafeBC, report must be received by WorkSafeBC within
five (5) business days from the date of the request. For invoicing purposes
the date of request is considered day zero (0).
Report Type Indicate by ticking the appropriate box whether the report is
an:
Provider Information
Name Enter the name of the treating Massage Therapist(s)
Payee number (vendor Enter the MSP Practitioner number of the treating RMT or the
number) Clinic Payee
Mailing Address Enter the physical address of the clinic/facility where the
service was delivered.
Clinic phone number Enter the phone number of the clinic where the Worker is
attending treatment.
Clinic fax number Enter the fax number of the clinic where the Worker is
attending treatment.
Worker Information:
Worker last name Enter the Worker’s last name. If possible, it should match the
name on the Worker’s British Columbia CareCard
First name Enter the Worker’s first name. If possible, it should match the
name on the Worker’s British Columbia CareCard
WorkSafeBC claim Enter the WorkSafeBC claim number specific to this injury.
number You can confirm the claim number by contacting the
WorkSafeBC Call Centre (1-888-967-5377)
Occupation Enter the title of the Worker’s Occupation
Clinical Report
Clinical Report Reports should include at least the following information:
Please note:
The payee number can be your MSP practitioner number for an individual therapist.
Clinics could also obtain a payee number for the clinic. The details that correspond to this
payee number will be used to issue payment. If you are an individual without a practitioner
number, or a clinic that wants to obtain a payee number, you will need to contact HIBC.
Payment Information
This coding is mandatory on all invoices submitted via MSP Teleplan. It allows for expedited
matching of invoices to claims, resulting in timely payment.
Service Information
• GST (where applicable) must be entered as a separate line item for each date of
service on the invoice using fee code 19332: “Good and Service Tax(GST)”
Provider Referrals
Lower Mainland: 604 231-8887
Toll-free: 1 866 481-8887
Fax: 604 233-9777
Toll-free Fax: 1 888 922-8807
Contract inquiries
Purchasing Services
Lower Mainland: 604 276-3344
Toll free: 1 888 967-5377, local 3344
Each SDL (Service Delivery Location) represents a WorkSafeBC office that provides
prevention, claims, account management and assessment services to workers and
employers of British Columbia, primarily directed to where the employer is located in the
province and often based on the employer’s industry. Each WorkSafeBC SDL provides
comprehensive and integrated day-to-day customer service for workers, employers and
stakeholders.
The SDL contact numbers are included below to be used in the case of urgent circumstance
where the provider may want to reach WorkSafeBC but the Board Officer is not available for
contact.