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
- 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.