Provider Expectations
A Trust provider will:
- do everything possible to assure that injured workers are seen immediately upon request but no later than 5 business days
of a request for an appointment.
- assure that the injured worker will be seen by one of the physicians listed in the Network Provider Directory.
- assess the injured worker’s ability to work, focusing treatment on returning the claimant to some type of work as quickly
and safely as possible.
- NOT determine that the injured worker is totally disabled without seeing the injured worker.
- complete and fax to the Trust the Employee Work Status Form the day of any visit. The provider will focus on capabilities
not disabilities.
- supply the Trust, within three (3) business days of ANY evaluation, a complete report on the claimant’s status,
including:
- patient history
- history of the current injury or illness
- current medical status
- treatment plans and goals
- follow-up date(s)
- as frequently as necessary to facilitate Return-to-Work (RTW)
- current work capacity, including specific work restrictions such as (but not limited to):
- number of pounds able to lift
- number of hours able to stand
- number of hours able to sit
- estimated RTW date
- without restrictions
- with restrictions
- maintain open communication with the claim management staff.
- comply with the Trust pre-certification requirements or risk reimbursement of said services.
- utilize the Network Provider Directory if a referral to another provider is needed and inform the Trust of said
referral.
- on referral, unless turning over full responsibility for treatment of the claimant, will remain the primary provider and
will maintain contact with the current treating provider.
- accept payment for services rendered in accordance with the Connecticut Workers Compensation Commission Fee Schedule or
other negotiated amount.
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