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From the Open-Publishing Newswire
"Dr. Das, speaking for the administration at the workers comp hearing in Oakland
Dr. Das who is the medical director of the Division of California Workers Compensation told doctors in the Workers Compensation that they should work for free in providing consultations for injured workers. Dr. Robert Weinmann wrote an article about how this would help the insurance industry deny injured workers proper health care in the present system which works against seriously injured workers.
"Dr. Das, speaking for the administration at the workers comp hearing in Oakland earlier this month, told the audience that the doctors who do consultations should be "advocates" for their patients and should prepare their consultation reports free of charge."
thursday, january 30, 2014
INSIDER REPORT FOR WORKERS COMP CONSULTANT DOCTORS
REVIEW OF RECORDS UNDER CODE 99358 HAS BEEN DELETED
While this report is aimed at doctors who are asked to do consultations for injured workers, its comments should be of interest to attorneys on both sides, insurance companies, adjusters, and injured workers. Most of the consultants who interview and examine injured workers know by now that Dr. Das, speaking for the administration at the workers comp hearing in Oakland earlier this month, told the audience that the doctors who do consultations should be "advocates" for their patients and should prepare their consultation reports free of charge. While well meaning, the remarks showed a lack of knowledge about how the system works. To begin with, consultations may also be requested by insurance companies, defense attorneys, and adjusters, not just by injured workers, applicants, and their lawyers. Das' remarks would put the defense consultant in the position of "advocating" for the insurance companies. In fact,, the consultant is supposed to provide an expert opinion as part of a search for truth. The consultant is not supposed to "advocate" for anything but the truth as it is believed by the consultant.
As to the free-of-charge remark, Dr. Das didn't acknowledge that the transcription fee for these reports is often in excess of one hundred dollars. Providing such reports free-of-charge amounts to a subsidy for the insurance companies which works against injured workers' interests. More to the point, medical offices would find that shelling out a hundred bucks to provide "free" reports is the straw that breaks the camel's back. The answer would be to stop doing consultations.
Here's how the money part worked under the OMFS or Official Medical Fee Schedule with reference to consultations requiring review of records which would be billed under Code 99358, now deleted as a billable code since January 1st.
99358 is, or was, the code number used to identify review of records, as in prolonged E & M services before and/or after patient care. Its standard reimbursement was $33.80 per unit. But the consultant would not be paid this amount because the insurance company would deduct $2.54 for what it called a "network" reduction, in other words, a payback to the MPN or Medical Provider Network which retained the consultant in the first place. Now that the code has been rescinded, the entire reimbursement to the consultant under 99358 has also been rescinded. Review of records may now enter a dark age of reduced enthusiasm.
Readers should ask the workers comp division of the Department of Industrial Relations to provide transcripts of Dr. Das' remarks to determine whether or not her remarks were accurately presented in this column.
Workers Comp Doctors Should Work For Free Says Dr. Rupali Das Of CA Division Of Workers Compensation
At a hearing in Oakland on January 14, 2014 by the California Division
Of Workers Compensation which is under the California Division Of
Industrial Relations Workers Compensation Medical Director
Dr. Rupali Das told the public that workers comp doctors should work
for free as advocates for injured workers. Long reports sometimes
20 pages are required under Utilizaion Review UR and Independent
Medical Review IMR. Dr. Das argues that these reports which are needed
to get medical care for injured workers should be done for free by the doctors.
Injured Workers National Network http://www.iwnn.org
Labor Video Project http://www.laborvideo.org
The California Workers Comp System and Injured Workers: Interview With Dr. Robert Weinmann
The continuing assault on the rights of injured workers in the obstacle
course for seriously injured workers is examined by Dr. Robert Weinmann.
Dr. Weinmann who is the former president of AFSCME Physicians and
Dentists Union talks about the issues facing injured workers and what is
happening to Doctors who treat injured workers under former laws SB 899
and SB 863. He also discusses the role of the California AFL-CIO on these
bills radically affecting seriously injured workers. The interview was done
on January 22, 2014.
For more information
Injured Workers National Network http://www.iwnn.org
Production of Labor Video Project http://www.laborvideo.org
Dr. Rupali Das who is the Medical Director of the California Division Of Workers Compensation told injured workers, doctors and advocates for injured workers that doctors should work for free who are examining injured workers.