Pricing

ISMS members: Free
Non-ISMS members: $75.00

Course Description

Physicians getting paid under the Illinois Workers’ Compensation system can be fraught with difficulties and frustrations. The complexity and bureaucratic nature of the system can lead to difficulties in navigating the medical fee schedule and delays in processing claims. Employers or their insurance carriers often dispute claims, requiring injured workers and their health care professionals to provide extensive documentation, and for patients to undergo independent medical examinations. These disputes can lead to prolonged legal battles, on top of billing and payment snafus, further delaying compensation.

The Illinois Workers’ Compensation system poses significant challenges for physicians, who may not fully understand how the system works or how to file and justify claims, and how to pursue unpaid claims within the system. This may be particularly challenging for physicians and medical practices who only dedicate a small portion of their practice to treating injured workers within the workers' compensation program, or for physicians who want to accept more workers' compensation patients but are not sure where to start.

Learning Objectives

At the conclusion of this learning activity, participants will be able to:

• Recognize how the Illinois Worker’s Compensation system works and pays medical providers for services provided to treated injured workers;
• Recognize how the Illinois Workers Compensation Commission (IWCC) Medical Fee Schedule works and how physicians bill and get paid for services;
• Identify common billing and payment issues faced by medical providers serving injured workers;
• Describe the key benefits of electronic billing for injured workers and the importance of completing all necessary claim element requirements to get paid; and
• Recognize how to assist attorneys in post-settlement enforcement of medical expense provisions.

Target Audience

ISMS members and their staffs

Disclosure

There are no relevant financial relationships with ACCME-defined commercial interests for anyone who was in control of the content of this activity.

CME information

The Illinois State Medical Society is accredited by the ACCME to provide continuing medical education for physicians.

The Illinois State Medical Society designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit^™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Illinois Nurse Practice Act rules deem CME credit provided by approved sponsors as acceptable to fulfill nursing continuing education requirements for licensure. Nurses may claim one contact hour per unit of CME in the state of Illinois.