The B.C. chiropractors shall comply with The Workers’ Compensation Act, The Health Professions Act (Chiropractors Regulation), the CCBC bylaws specifically regarding Scope of Practice, Code of Ethics, Personal and Professional Conduct, and Delegation and Supervision.

Pursuant to section 21 of the Workers Compensation Act, WorkSafeBC implemented a Chiropractic Services Memorandum of Agreement effective October 11, 2010. Chiropractors are not required to sign this Agreement. However, all chiropractors providing treatment to injured workers are deemed to have accepted the terms of the Chiropractic Services Memorandum of Agreement regardless of their status with the BC Chiropractic Association (BCCA). Chiropractors not wishing to accept the terms of the Agreement should not provide treatment to injured workers.

WorkSafeBC billing is a combination of flat fee and fee-for-service models. The Agreement provides for a flat fee model for most services. The number of treatment visits can be claimed with only two visit forms: 8C and 11C. The services excluded from 8C and 11C can can be billed with WorkSafeBC invoices on fee-for-service model. The fee-for-service model also applies to treatments offered beyond the eighth week.

Chiropractic treatment may be provided for up to a maximum of eight (8) weeks, unless extended or related to the spinal cord injury.

WorkSafeBC claim numbers are not mandatory because patients are often treated before they have made a WorkSafeBC claim. However, since patients usually have a claim number within two weeks of initial treatment, the chiropractor should add the claim number to the subsequent billings (and any worker document) as soon as it is available to help WorkSafeBC match the invoice/report with a valid WorkSafeBC claim and to speed up the payments.

The chiropractors submit two types of electronic billing items to WorkSafeBC: the report 8C/11C and the invoices. All the billing items should be submitted to WorkSafeBC withing 90 days of the service date. Late billing items might not be paid. Some billing items, such as the Chiropractor’s Initial Report 8C might have even stricter individual deadlines. The billing items submitted after the individual deadlines but within 90 days will be paid but their payments will be reduced because of late time penalties.

When booking an initial appointment ask the patient if the injury occurred at work. The Workers’ Compensation Act requires that the Chiropractor’s Initial Visit Report 8C be submitted for any person who has had an accident at work. The F8C should be submitted even if the injured worker is not sure if they want to register a claim with WorkSafeBC in order to not delay the claim process should the worker decide to proceed with a claim, which is often the case.

If the injury occurred at work, ask if WorkSafeBC opened a claim number.

If the patient has a WorkSafeBC Claim Number

If the claim was already registered with WorkSafeBC, WorkSafeBC will only pay for the services under eligible claims. Chiropractors are required to confirm the status of the WorkSafeBC claim before billing WorkSafeBC.

If the patient has no WorkSafeBC claim number

If there is no claim number yet, the chiropractor still can and should submit the Form 8C to WorkSafeBC. The Form 8C will be paid for regardless of claim status outcome.

CHECK WORKSAFEBC CLAIM STATUS ONLINE

• Go to WorkSafeBC Claim Status portal
• Enter
  • your MSP practitioner number
  • WorkSafeBC claim number
  • patient’s personal health number

 

Call WorkSafeBC call centre at

• 604-231-8888 or
• toll free 1-888-967-5377
• Monday-Friday 8:00 a.m.-6:00 p.m.

The WorkSafeBC claim is valid if

• the claim status is active and
• the claim eligibility is allowed and
• at least one injury is accepted and
• the claim’s effective date (injury date) is less than 8 weeks prior to the initial treatment date.

Chiropractor’s Initial Visit Report 8C

Please note that you do not need to download and complete the report if you are using Claim Manager. The report is completed and submitted to WorkSafeBC electronically.

The F8C is a flat fee item. The fee for the F8C covers the first two visits and the expense of filling out and submitting the F8C electronically.
The Initial Visit includes

• assessment,
• diagnosis,
• treatment, if indicated, and
• general education with the goal of early and safe return to work.

If the patient has an open WorkSafeBC claim, the chiropractor must check the WorkSafeBC claim eligibility status before submitting F8C.
If there is no claim yet or claim is pending, the chiropractor still should submit the Form 8C to WorkSafeBC. The Form 8C will be paid for regardless of claim status outcome. The patient must not be billed.

The date of service on the F8C is the date of the initial visit.

• The F8C must be successfully received by WorkSafeBC within five calendar days following the initial visit to be reimbursed the full amount; Day zero (0) is considered the date of the Initial Visit. Late forms are penalized. The F8C cab be billed before the second visit has occurred.
• The electronic F8C form goes to WorkSafeBC via MSP Teleplan. The Teleplan validation job might decline the form (usually within three calendar days after the submission). The declined form needs to be corrected and resubmitted in time to avoid the late penalty. Claim Manager validates the form to help it pass the Teleplan validation.
• The F8C is successfully received by WorkSafeBC only if it passes Teleplan validation stage. The F8C that does not pass Teleplan validation never reaches WorkSafeBC. The declined F8C can be corrected and resubmitted as many times as needed.

• The F8C must be submitted electronically; faxed forms are penalized.
• The F8C submitted in Claim Manager constitutes an invoice. No separate WorkSafeBC invoice is required.
• Forms submitted by fax do not constitute an invoice. If the form is faxed, the fee item still needs to be billed in Claim Manager using WorkSafeBC Invoice form.

• The Chiropractor shall be reimbursed for only one (1) Chiropractic First report fee per claim.
• Fee item code is 19134 – Chiropractic First Report (Form 8C)
• Fee amount is $102.75.

• Late reports are penalized by $15.00.
• Faxed reports are penalized by $40.53.
• A late report that is faxed is subject to both penalties, which add up to $55.53. Amount paid is only $47.22.

• To get paid at a highest WorkSafeBC rate, submit F8C with Claim Manager on the date of the treatment. That will allow time for correction if necessary.
• It is better to submit a late electronic report than a timely report by fax. If you are in a transitional stage between billing software, hold off submitting your 8C report by fax. Do it electronically after you enroll with your new billing provider. The penalties will be less.

If you took X-rays during the initial visit, bill for them separately. They are not included in WorkSafeBC report 8C. Claim Manager allows to create electronic invoices to bill for services excluded from F8C and F11C.

X-ray invoice requires Form 11RC – Chiropractor’s X-ray Report. See details bellow.

The patient must not be billed.

The Chiropractor’s Progress Report 11C

F11C is exactly the same as F8C. Please note that you do not need to download and complete the report if you are using Claim Manager. The report is completed and submitted to WorkSafeBC electronically.

The F11C is a flat fee item. The F11C commences on third visit and includes all visits up to and including the eighth week. The F11C treatments may include

• education focused on activities of daily living and early return to work following injury,
• development of a Return to Work (RTW) plan,
• home visit,
• supplies provided to the Injured Worker up to the value of $50.00. (Authorization must be received from a Claim Owner for supplies over $50.00.)

No other fees are billable in the initial 8 weeks of treatment, except for x-ray reports, if any.

• If the Form 11C is being submitted at the end of the fourth week of treatment it must include
  • objective findings,
  • a plan for clinical recovery and return to work or
  • recommendations for alternate investigation or treatment.
• If the Form 11C is being submitted at an early discharge it must include
  • the worker’s status at discharge,
  • a return to work plan, if applicable.

• The F11C is billable only if the worker has been seen more than twice.
• Unlike the F8C, the F11C can only be billed on accepted claims if the worker has been approved for chiropractic treatment. The chiropractor must check the claim’s eligibility status before commencing the third treatment.

The date of service on the F11C is the last visit date before writing the F11C.

The F11C must be successfully received by WorkSafeBC

• by the end of the fourth week of treatment or
• at discharge (whichever comes first),

Unless the F11C is submitted at a discharge, it must not be billed before the end of the 4th week.

• The F11C must be submitted electronically; faxed forms are penalized.
• The F11C submitted in Claim Manager constitutes an invoice. No separate WorkSafeBC invoice is required.
• The F11C submitted by fax does not constitute an invoice. A separate WorkSafeBC invoice is required.

• Only one (1) Chiropractic Treatment and Progress/Discharge Report F11C flat fee can be billed per claim per payee.
• Fee item: 19135 – Form Fee (11C).
• Fee amount: $493.00

• Faxed reports are penalized by $23.78.
• There is no penalty for submitting F11C late.

• To get paid at a highest WorkSafeBC rate, submit F11C with Claim Manager. It is better to submit the report late electronically than fax it on time because there is no penalty for late form submission but there is penalty for fax submission.
• If you forget to submit F11C by the end of the fourth week of treatment, you can submit it at any time but make sure to indicate the service date of the report that corresponds to the last visit during the 4th week of treatment.

X-rays are not included in F11C. If you take X-rays within eight weeks, bill for them in Claim Manager using WorkSafeBC invoices with the fee item codes

• 19138: $59.86 – Spinal Series,
• 19139: $23.19 – Spinal Series recheck,
• 19140: $42.98 – Peripheral joints.

X-ray invoice requires Form 11RC – Chiropractor’s X-ray Report. See details bellow.

• It the patient has spinal cord injury, the chiropractor must specify on the F11C the intent to continue treating beyond 8 weeks, including the frequency and duration of treatment.
• No Form 83D62 is required to extend treatment time beyond eight weeks.

if the worker has not been approved for chiropractic treatment, the chiropractor can bill the patient.

• Service date must be within a Board Officer approved Chiropractic Treatment period.
• Each X-ray invoice must be preceded by the Chiropractor’s X-ray Report 11RC.
• Limit of one 19138, 19139 and 19140 payable per accepted claim per Payee.

Form 11RC – Chiropractor’s X-ray Report (PDF 129kb, 2 pages)

Fax the Chiropractor’s X-ray Report 11RC to

• 604 233-9777 or
• toll-free 1 888 922-8807

WorkSafeBC does not accept electronic 11RC.

• Bill for X-rays only after successful submission of F11RC;
• Bill for X-rays in Claim Manager using WorkSafeBC invoice form;
• Submit electronic WorkSafeBC invoice for only one fee item: 19138, 19139, or 19140.

• 19138: $59.86 – Spinal series,
• 19139: $23.19 – Spinal series recheck,
• 19140:$ 26.70 – Peripheral joints.

Communication with the WorkSafeBC Board Officer or designate and/or the employer or other health care practitioners may be required during the course of treatment.

Phone Consultation – Eligibility

• Board Officer and/or a Chiropractor initiated phone call shall be reimbursed up to a maximum of fifteen (15) minutes when the discussion involves:
  • Treatment progress;
  • Return to work planning;
  • Discharge planning; and
  • Recommendations for further or alternative intervention programs or services.
• Phone calls shall not be reimbursed for the discussion of administrative, payment or performance issues of the Chiropractor.
• Employer consultation must be authorized by the Board Officer for telephone communication of up to fifteen (15) minutes with Employers.
• Phone calls must be documented to include date, time, Employer’s contact name and a summary of the discussion.
• Not to be billed in multiples.

Phone consultation – How to Bill

Bill phone consultation in Claim Manager with WorkSafeBC invoice.

Fee Item Code – 19132

• Fee item code: 19132 – Telephone Consultation with Board Officer/Employer
• Fee amount: $46.00.

This fee for chart notes is billed when WorkSafeBC requests that the chiropractor fax in a copy of the injured worker’s chart notes. Being a flat fee, the amount billed for this fee code is the same regardless of the number of pages sent to WorkSafeBC.

Chart Notes – Eligibility

• Flat rate fee;
• Can be billed only after a specific request by WorkSafeBC;
• Not payable with a 19141 or 19144.

How to Bill

• Fax the notes;
• Bill in Claim Manager using WorkSafeBC invoice with the fee item 19142.

Fee Item Code – 19142

• Fee item: 19142 – Photocopies of Patient’s Record (Chart notes);
• Fee amount: $26.34.

There are two types of reports that WorkSafeBC can request from the chiropractor: a written report and a comprehensive report.

Requested Reports – Billing Eligibility

• A written report and comprehensive report are payable only when requested by a Board Officer;
• Only one of the reports are payable per a claim;
• The reports are not payable with 19142 – Photocopies of patient’s record.

How to bill

• Fax the report to WorkSafeBC;
• Bill in Claim Manager using WorkSafeBC invoice and with fee item 19141 or 19144.

Fee codes

• 19141: $42.98 – Written Report
• 19144: $209.59 – Comprehensive Report Requested by WorkSafeBC

The JSV/Assessment may include any or all of the following:

• A brief review of work tasks;
• Confirmation of the Injured Worker’s critical job demands;
• Exploration of simple job modifications and return to work options;
• Consultation with the employer and other relevant stakeholders, to establish an appropriate return to work plan;
• Communication/education of the employer regarding RTW opportunities;
• Ongoing support of GRTW Plan including, job coaching/shadowing;
• up to one (1) hour of return travel time;
• the JSV Report;
• any subsequent JSV/Assessment when the subsequent JSV/Assessment is in follow-up to the initial Job Site Visit and related to the same job opportunity.

All Occupational Health and Safety Regulations must be adhered to while conducting any Job Site Visit/Assessment.

The JSV report must be submitted to the WorkSafeBC, the Attending Physician and other health care providers involved in the Injured Worker’s care.

Job Site Visit report must be faxed to WorkSafeBC.

• The Report should be received within five (5) calendar days of the date of the Job Site Visit/ Assessment
• Day zero (0) is considered the date of the Job Site Visit/ Assessment.

• Fee item code: 19718 – Job Site Visit/Assessment;
• Fee Amount: $265.00.

• Bill for the JSV/Assessment Report after it is received by WorkSafeBC.
• Limit ONE (1) JSV/Assessment Report per payee per accepted claim.
• Bill for the report in Claim Manager using the WorkSafeBC invoice and fee item 19718.

A penalty of $55.00 is applied if the JSV report is received after five (5) calendar days following the JSV.

Job Site Visit Report (form 83D201), pdf (332K)

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New JSV and Gradual Return to Work (GRTW) report templates and reporting guidelines, pdf (936K)

Where the severity and chronicity of the medical condition of the Injured Worker requires long term, periodic on-going treatment in regard to including but not limited to spinal cord injuries (example para/quadriplegia, decreased mobility) the Chiropractor may continue to provide treatment beyond eight (8) weeks. The approval for providing the treatment is required.

How to obtain an approval for spinal cord injury billing

• Specify on the F11C that you intend to continue treating, including the frequency and duration of treatment.
• Do not submit the Request for Extenuating Circumstances Treatment; only the F11C report is required to be submitted by the end of 4 the week of treatment in order to request approval for Spinal Cord Injury treatment.

Spinal Cord Injury Fee Code

• Bill spinal injury billing code after the F8C and F11C flat fees and the initial 8 weeks of treatment have been completed;
• Do not bill before you receive approval from WorkSafeBC;
• Bill only one visit per day in accordance with the approved treatment plan:
  • Fee item: 19149 – Spinal Cord Injury Treatment
  • Fee amount: $40.53.

If the chiropractor feels that it is medically necessary for the worker to have treatment beyond the initial eight weeks of treatment, the chiropractor can request Extenuating Circumstances Treatment. The request will be reviewed by the Liaison Committee and referred to the Claim Owner for final authorization.

Extenuating Circumstances Treatment and Request Form

To request the extension of treatment beyond eight weeks, the chiropractor needs to submit: Form 83D62 – Extention of Chiropractic Treatment Request – Extenuating Circumstance (PDF 173 kb, 2 pages)

Form 83D62 – The Content

• The Form 83D62 should provide evidence and rationale for additional treatment.
• The Form 83D62 must include information regarding a proposed treatment plan, the start and end date, and the proposed number of additional treatments being requested.

Form 83D62 – Submission Deadline

• The Form 83D62 should be submitted by the end of the 5th to 6th week of treatment.
• The Claim Owner’s decision is usually provided by the end of the 8 weeks of treatment.
• The Form 83D62 is not required for Spinal Cord Injury treatment beyond 8 weeks.

Form 83D62 – How to Submit

• The Form 83D62 must be faxed to WorkSafeBC
  • 604.233.9777 or
  • 1.888.922.8807.
• WorkSafeBC does not accept electronic 83D62.

Fee code: 19148 – How to Bill The Form Fee

• Bill the F83D62 form fee only if the form is approved.
• The fee code 19148 is a fee-for-service item. Bill the fee in Claim Manager with the WorkSafeBC invoice.
• Fee code: 19148 – Extenuating Circumstances Treatment Form Fee.
• Fee amount: $23.78.

Fee code: 19147 – Extenuating Circumstances Treatment

• Extenuating circumstance treatment is a fee-for-service item. If the extended treatment is approved, billing will be payable on a per visit basis.
• Bill for the treatment for extenuating circumstance only if the Form 83D62 is approved.
• Bill the fee in Claim Manager with the WorkSafeBC inovoice.
• Only one visit per day is payable as per the approved treatment plan.
• Fee code: 19147 – Extenuating Circumstances Treatment – Visit
• Fee amount: $30.75.

 

To confirm that WorkSafeBC received your electronic F8C/11C or an invoice, WorkSafeBC usually includes the report/invoice in the next remittance report, even if it has not been processed yet. The invoice/report is shown with the explanatory code BK. This code shows that the submission is pending and there is no need to re-bill.

To check the status of submitted WorkSafeBC report or an invoice, visit

• WorkSafeBC portal to view the payment invoice status

For electronic submissions, you need to enter

• Payee MSP number (usually treating practitioner)
• Data Centre number
• WorkSafeBC claim #

For faxed submissions, you need to enter

• Payee MSP number (usually treating practitioner)
• Invoice Ref #

Invoice Ref # – The Invoice Reference Number is the number that you (the provider) include on your invoices to identify yourself and to help with reconciliation. Invoices that do not include an Invoice Reference Number cannot be searched. Always create an Invoice Ref # for your faxed reports and invoices.

Chiropractors submitting WorkSafeBC invoices in Claim Manager do not need to fax their invoices. They submit all invoices electronically.

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Quick Guide to WSBC invoice status portal

• Learn how to read the status report in the Quick WorkSafeBC Guide

To check the status of submitted invoice or report, call WorkSafeBC call centre at

• at 604-231-8888 or
• toll free 1-888-967-5377.

 

The chiropractor is not allowed to bill WorkSafeBC patients directly. The only exception is billing the WorkSafeBC patients for treatments not related to the work-related injury. Workers who attend for work-related injuries may elect to have treatment to areas other than the injured area accepted on the claim. The chiropractor may charge a fee when treatment is provided to a NON-claim related area. The worker must acknowledge their understanding prior to the treatment being provided that this fee is their responsibility and will not be reimbursed by WorkSafeBC.

If a patient is initially treated as a private patient and subsequently the Chiropractor learns that the worker has an accepted WorkSafeBC claim, all costs associated with the services must be reimbursed to the injured worker, and the Chiropractor must bill WorkSafeBC as per Schedule B of the Memorandum of Agreement. This is a legal obligation according to the Workers’ Compensation Act and must be followed even if the Chiropractor has decided not to treat injured workers or bill WorkSafeBC directly. No additional fees for services related to the area of injury accepted on the claim may be charged to the injured worker.

If the patient’s Personal Health Number has expired or he is not longer a British Columbia resident, your reports and invoices will be declined with the refusal code “AA”. Such claims and invoices must be resubmitted by fax.

How to avoid refusal code AA

• Use Claim Manager to check the MSP status of the patient before submitting a WorkSafeBC report and/or invoice.
• If MSP coverage is invalid on the date of service, your patient’s PHN can no longer be used.

WorkSafeBC Billing Rules for patients with no PHN

• If an injured worker does not have a Personal Health Number, the Form 8C/11C and/or invoices must be faxed.
• The paper invoices must be faxed within 90 days of the date of service to be paid.
• No penalty is applied for faxed report in this case.

Form 267 –  Invoice for treatment services (PDF, 66 kb, 1 page)

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Form 8C/11C – Chiropractor’s report (PDF, 120 kb, 2 pages)

F8C/11C Fax Submissions

• If the chiropractor has to submit the F8C/11C by fax, type it in to maximize legibility;
• Create and include the Invoice Reference Number in the faxed F8C/11C. Invoices/forms that do not include an Invoice Reference Number cannot be searched online to check the invoice/report payment status;
• Follow up the faxed F8C/11C with the electronic or faxed invoice for the item code 19134/19135 to get paid for the form.
• If the chiropractor has to submit F8C/11C in response to a phone or letter request by a Claim Owner, penalties still apply for reports submitted by fax;
• If you have submitted the form by fax but it was not processed by WorkSafeBC yet, it might be possible to resubmit it electronically and waive the penalty for fax submission.

To fax Form 8C/11C

• 604 233-9777 or
• 1 888 922-8807.

If additional space is required for reporting clinical information on the F8C/F11C, use the Practitioner’s Addendum (PDF 92kb).

Visit WorkSafeBC web page for chiropractors

• WorkSafeBC for chiropractors

Download

• Chiropractic Services Memorandum of Agreement
• Schedule A – Description of Services
• Schedule B – Fee Schedule
• Schedule C – Privacy Protection

Contact WorkSafeBC Teleclaim team to find out if a claim has been submitted and accepted, or for general claims inquiries. Teleclaim should be your first point of contact for claim matters.

• Lower Mainland: 604 231-8888
• Toll-free: 1 888 967-5377
• Working hours:
  • check the claim status: 24/7
  • other inquires: Monday-Friday 8:00 a.m.-6:00 p.m.

Contact WorkSafeBC Payment Services team for information on our billing requirements.

• Lower Mainland: 604 276-3085
• Toll-free: 1 888 422-2228
• Monday – Friday: 7:30 a.m. – 4:00 p.m.

• Lower Mainland: 604 233-9777
• Toll-free: 1 888 922-8807

PO Box 4700 Stn Terminal Vancouver, BC V6B 1J1

Contact WorkSafeBC Health Services team for questions about reporting or your contract.

• Lower Mainland 604 232-7787
• Toll-free 1 866 244-6404
• Monday – Friday: 8:00 a.m. – 4:00 p.m.

Contact WorkSafeBC Purchasing team for information on contracting your services and supplies.

• Phone: 604.276.3344 (Lower Mainland)
• Toll-free: 1.844.276.3344 (B.C.)
• Hours of operation: Monday to Friday, 8 a.m. to 4 p.m.
• Email: purchase@worksafebc.com