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12:09:52 PM CDT
Wednesday, July 30, 2014

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Utilization Review
April 2014
Quick Tips for Chiropractors

A new document, Quick Tips for Chiropractors, is available for chiropractors to reference regarding WSI treatment and authorization policies.

The document addresses frequently asked questions such as window periods, modalities, approval of chiropractic treatment, acupuncture and massage therapy.

If you have questions about this article, please send an email to wsipr@nd.gov. To receive provider news, subscribe to our Email Updates list.

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February 2014
Post Injection Pain Response Note now Available

A new form, Post Injection Pain Response Note, is available for providers to document response to an injection. The form contains pertinent information WSI requires for additional injections, which may not be included in the medical documentation.

The intent of the Post Injection Pain Response Note is to supplement the documentation; its use is not mandatory. The new form does not replace the necessity of the UR-C form to request additional injections.

If you have questions about this article, please send an email to wsipr@nd.gov.

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December 2013
Change of Therapy Initial Window Period

Effective January 1, 2014, WSI will change the methodology of counting therapy services. The first evaluation will be included in the initial window period of 10 visits or 60 days of care whichever comes first. This is regardless of whether or not treatment was provided on the same day as the evaluation.

For more information on therapy services, please refer to Utilization Review section of our website.

If you have questions about this article, please send an email to wsipr@nd.gov.

...Read More >>
June 2013
Quick Tips for Physical & Occupational Therapists

A new Quick Tips information sheet for physical and occupational therapists regarding WSI treatment and authorization has been released.

The document addresses frequently asked questions such as window periods; modalities; approval of therapeutic exercises; and work conditioning/work hardening. To view the Quick Tips, click here.

If you have questions about this article, please send an email to wsipr@nd.gov.

...Read More >>
May 2013
Utilization Review Guide Updated

The Utilization Review Guide has been updated to reflect the addition of three new pilot programs (emergency inpatient admissions; EMG testing; and MRIs) and the criteria for the workability assessment criteria. More information on the pilot programs can be found under the Utilization Review topic to the right.

The UR Guide is updated throughout the year; providers are encouraged to periodically review the document for updates.

If you have questions about this article, please send an email to wsipr@nd.gov.


April 2013
Utilization Review Pilot Programs Effective May 1, 2013
Effective May 1, 2013 WSI will implement three new pilot programs relating to utilization review for services. Prior authorization will no longer be required for the following:
  • Emergency in-patient admissions during any part of the claim
  • EMG and nerve conduction testing (NC Stat, Neurometric and Surface EMGs are still non-covered services)
  • MRI performed within the first 60 days from the date of injury (only one allowed per claim and must be related to work injury)

Final liability and payment decisions are the responsibility of the claims adjuster managing the claim.

Please note, one or more of the pilot programs may be updated or discontinued at any time. Providers are encouraged to check for updates to these programs on WSI's website under the Providers News section.

If you have questions about this article, please send an email to wsipr@nd.gov.

...Read More >>
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