Utilization Review News

April 2019
Effective April 1, 2019, WSI will no longer require all total knee arthroplasty procedures be performed in the inpatient hospital setting. The Utilization Review (UR) department will now allow for the approval of a total knee arthroplasty described by CPT
March 2019
WSI has recently received an increase in incomplete prior authorization requests for elective lumbar fusion surgeries.
August 2018
Effective October 1, 2018, WSI will implement a change to the window period allowed in the existing chiropractic pilot program.
December 2017
Effective January 1, 2018, WSI will implement a change to the chiropractic pilot program.
June 2017
Based on provider feedback, WSI has outlined some points of clarification for providing chiropractic treatment to an injured worker.
June 2017
WSI recently revised several Utilization Review (UR) forms, which a provider should use effective immediately.
June 2016
Effective July 1, 2016, WSI is initiating a pilot program in which a chiropractor will be required to obtain prior authorization for chiropractic treatment extending beyond the initial office visit.
May 2016
Effective June 1, 2016, WSI will only accept a request to retrospectively review a rendered service that was not prior authorized after the provider has submitted a bill and received a denial for that service.
April 2016
WSI recently revised the UR-Chiro form and providers should use the revised form effective immediately.
March 2016
Effective April 1, 2016, Workforce Safety & Insurance (WSI) will require submission of the newly developed Pain Questionnaire and Surgery Expectation Questionnaire forms when requesting a prior authorization request for a lumbar fusion surgery.