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DWC Releases New Version of Physician’s Guide to Medical Practice in the California Workers’ Compensation System

March 31, 2016 by Catherine Montgomery

For the first time in 15 years, the Department of Workers’ Compensation (DWC) released a new edition of its Physician’s Guide to Medical Practice in the California Workers’ Compensation System.

Workers’ comp in California underwent seismic changes in those 15 years, including SB 863 reforms, introduction of the RBRVS-based fee schedule, and implementation of electronic billing. In the 127-page guide, the DWC incorporates these changes in its comprehensive coverage of the workers’ comp system for health care providers.

Workers’ comp has also become much more complicated in the last 15 years (understatement of the month), so this edition of the guide includes six new chapters:

  • Chapter 4. Participants in the System
  • Chapter 5. Benefits and Payments to Employees
  • Chapter 7. Reports and Timelines in the System
  • Chapter 8. Evidence-Based Medical Guidelines and the Medical Treatment Utilization Schedule
  • Chapter 9. Utilization Review (UR) and Independent Medical Review (IMR)
  • Chapter 13. Payment of Physicians and the Official Medical Fee Schedule (OMFS), RBRVS, E-Billing, and IBR

Here at DaisyBill, we are particularly fond of Chapter 13 and its coverage of electronic billing.

Also of note:

  • Practical how-tos for physicians, such as sections in Chapter 3 which set out how to take an occupational history and how to analyze causation.
  • Answers to frequently asked questions scattered throughout the guide.
  • Handy links to forms and relevant regulation sections.
  • Inclusion of copy services and interpreters in the OMFS.
  • The DWC, in the announcement for the guide (Newsline No.: 2016-33), suggests that the guide should be helpful to Qualified Medical Evaluators (QMEs) and those preparing for the QME certification exam.

Although targeted primarily at medical providers, the guide is useful to any professional working in the workers’ comp space. Even seasoned veterans of workers’ comp will find new information or timely refreshers in the guide. Good job DWC!

The guide is free to download. Access it through the DWC website or by clicking here.

For another overview of California’s work comp system, check out our free webinar.

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