Services not Reimbursable by WSI

March 2018

WSI does not provide reimbursement for services considered unnecessary to treat or diagnose a compensable work injury.  This includes services generally considered preventive.  Below are some examples of the services billed to WSI in error. 

Services unnecessary to treat a work injury:

  • Treatment for communicable diseases (e.g. common cold)
  • Treatment for seasonal disorders (e.g. allergies)
  • Treatment for pre-existing conditions (e.g. diabetes)

Services generally considered preventive:

  • Flu vaccine
  • Mammogram
  • Pap smear

There are circumstances in which a provider may render one or more of these services concurrently with the treatment of a work injury.  If this should occur, a provider should not bill WSI for the services unrelated to the work injury.  For these services, it is appropriate for a provider to pursue direct reimbursement from the patient or other insurance.

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