Exception: | When a provider treats an injured worker for condition(s) unrelated to the worker's accepted industrial injury or illness, the provider may bill the worker or other insurers for the unrelated services only. |
(3)
What services will be paid to providers outside of Washington? Only those diagnostic and treatment services authorized under the state of Washington medical aid rules, fee schedules, payment policies, or medical coverage decisions may be authorized or paid by the department or self-insurer. As determined by the department of labor and industries, the scope of practice of providers outside the state of Washington may be recognized for payment purposes. However, in all cases WAC
296-20-03002 (Treatment not authorized) shall apply. Specifically, services not authorized under Washington workers compensation rules, fee schedules, payment policies, or medical coverage decisions will not be paid, even if permitted under the workers compensation program in the provider's state or country of business. When in doubt, the provider should verify coverage of a service with the department or self-insurer.
[Statutory Authority: RCW
51.04.020,
51.04.030,
51.36.080. WSR 00-09-078, § 296-20-022, filed 4/18/00, effective 7/1/00. Statutory Authority: RCW
51.04.020(4) and
51.04.030. WSR 90-04-057, § 296-20-022, filed 2/2/90, effective 3/5/90; WSR 87-24-050 (Order 87-23), § 296-20-022, filed 11/30/87, effective 1/1/88; WSR 87-03-004 (Order 86-45), § 296-20-022, filed 1/8/87.]