How to Make a Correction or Add an Addendum to a RateFast Report

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Update for 2021: RateFast Express is an even easier alternative to the wonderful RateFast software. We write your workers’ comp impairment reports for you. Try RateFast Express today!

This post is for RateFast users who want to make a correction, fix a typo, or add additional content to a RateFast report that has been closed and signed.

Picture this: a provider has reviewed and signed the RateFast report. The report is now closed and can no longer be edited.

But wait. There’s a typo.

Continue reading How to Make a Correction or Add an Addendum to a RateFast Report

RateFast’s Roadmap to Apportionment

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Apportionment is one of the top three decisions which can delay a WorkComp claim from closing. This is understandable, as it’s a tricky subject. Nearly all medical providers have a different idea about how apportionment should be arrived at. Insurance companies want to pay the injured worker the right price, the injured worker needs to be adequately compensated… And the employer only wants to be responsible for the part of the injury which was caused at work.

Bottom Line: There are no clear rules with apportionment. Although the law defines that only “permanent disability” is to be apportioned, there are no instructions on how the medical provider is to actually do it. Is it functional disability (eg. could lift 20 pounds before the injury and now lifts only 10 pounds)? Is it “permanent disability” from a permanent disability rating (PDR) that results from an impairment measurement (eg. %Whole person impairment, which may or may not result in true permanent functional disability). Or, is it a change in treatment burden such as medications, therapy, and or other measurable medical support that is now needed, new, or increased from a pre-injury condition to maintain the new level of function? Which one is a correct method? They can all be used clinically with equal defensibility when correctly explained and supported.

There are a few things which can be referenced when deciding apportionment, in order to keep consistent, objective impairment reports.

Let’s start with some definitions.

  • Apportionment is one of the subsets of the PR-4 report.
  • It’s a section where the medical provider is asked to make a determination if the permanent disability that results from the work injury may be attributed medically to any other conditions.

Now time for a real-world example.

A gentleman who is 25 y/o is lifting a box at work. He injures his back and receives treatment. At the conclusion of the report the doctor is going throught the case history and it turns out that the worker had a pre-existing injury to his back. This placed him on a restriction from listing more than 20 pounds. After this new injury he can only lift 10 pounds.

Is apportionment present and if so, what %?

The answer is yes. He is 50 % apportioned to his permanent disability from the old, unrelated event when he hurt his back.

In this case we’re lucky enough to have a clear a baseline of pre-existing disability, we know the worker is at MMI, and now there’s a new level of permanent disability. This makes the apportionment determination much simpler, and helps with the timely closure of the claim. Remember apportionment is no walk in the park, so if you’re looking for any advice feel free to Submit a PR-4 report for review today!

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Never Fill Out an RFA again: How to Write and Track RFAs in RateFast

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Whenever you order a treatment for an injured worker, you also need to complete a Request for Authorization form. Completing and keeping track of RFAs for every treatment and referral isn’t always easy. And it’s never fun. We know.

Fortunately, there’s now a solution.

Continue reading Never Fill Out an RFA again: How to Write and Track RFAs in RateFast

How to Simplify ICD-10 Codes Using RateFast

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Update for 2021: RateFast Express is an even easier alternative to the wonderful RateFast software. Try RateFast Express today!

As of October 1st 2015, U.S. medical providers are required to use ICD-10 codes instead of ICD-9 codes.

Although there are more than 70,000 new codes (many of which feature an overwhelming amount of specificity) we believe that this transition can—and should—be simplified with the help of medical software.

Continue reading How to Simplify ICD-10 Codes Using RateFast

Automatic billing for your PR-4 reports! How to use the RateFast Billing Calculator

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Update for 2021: RateFast Express is an even easier alternative to the wonderful RateFast software. Try RateFast Express today!

Accurately sending your bill for a PR-4 report can be a time consuming process, but it doesn’t need to be.

The RateFast PR-4 Billing Calculator counts the amount of pages in your PR-4 report, asks some basic questions, and then prints out a bill at the end of your report.

This article describes how to turn on the billing calculator and how to use it correctly.
Continue reading Automatic billing for your PR-4 reports! How to use the RateFast Billing Calculator

Try the new version of RateFast

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If you’re reading this on our blog, then you can see that the RateFast website has undergone a major overhaul. But it’s not just the exterior that’s new and improved. The new version of the RateFast application has a ton of new features.

Here are just a few of the benefits:

Write reports anywhere

Use any computer or tablet with internet access to write, print, and securely store Doctor’s First Reports, PR-2 Reports, and PR-4 reports.

Impress insurance carriers with your thoroughness

The software guides physicians through exams according to the rules outlined in the AMA Guides. You’ll ask all the right questions and take all the measurements necessary to produce a perfect work-comp report.

Receive laser accurate impairment ratings

Gone are the days of staying late at the office figuring out your patients’ impairment ratings. When you write a PR-4 report using RateFast, you’ll receive an accurate and justifiable whole person impairment, complete with references to specific sections and rules in the AMA Guides.

Send out grammatically correct, perfectly formatted reports

RateFast reports are written in conversational language and formatted like the official forms by California’s Division of Workers’ Compensation. You can preview your reports in your secure account, download them as digital documents, and print them out.

Get your whole team involved

Now, your entire clinic can help move work-comp claims forward. Administrative staff, nurses, physician’s assistants, and MDs can all manage work injuries and contribute to reports.

 

 

RateFast is completely free to join: you’ll get 2 free reports to start.

To learn more, call us at (707) 304-5949 or email us at info@rate-fast.com.

How to measure range of motion for a PR-4 report

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If your patient has injured a joint, then you (the medical provider) should be sure to measure the range of motion (ROM) of that joint. It’s particularly important to report the range of motion of an injured joint in a PR-4 Report (or the PRIMARY TREATING PHYSICIAN’S PERMANENT AND STATIONARY REPORT).

Why?

Measuring the range of motion for an injured joint is essential for calculating an accurate impairment rating.

If you don’t know how much motion your patient has lost, then you can’t tell how much the work injury impaired him or her.

4 Steps to taking accurate range of motion (ROM) measurements for work comp

1. Have your patient warm up by stretching for two minutes

If your patient warms up before measuring, then your measurements  will be more accurate and consistent, with greater reproducibility.

Reproducibility of measurements within 10% is necessary for measurements to be considered valid by the AMA guides.

2. Use the proper tool

If the joint is in the upper or lower extremity (arm or leg), then use a goniometer.

If the injured joint is in the spine, then use an inclinometer.

3. Measure both sides

Notice that the PR-4 report says “Include bilateral measurements – injured/uninjured – for injuries of the extremities.”

So, if your patient has injured her right shoulder, then measure the range of motion of both shoulders. This shows the contrast between the injured body joint and the uninjured joint.

Unless, of course, both sides are injured! But in this case, you should still measure both sides and report your measurements.

4. Measure multiple times!

If the injured joint is in the upper extremity, then take two measurements across each plane (flexion, extension, etc.).

If the injured joint is in the lower extremity or the spine, then take three measurements across each plane.

5. Report your results in the “Physical Examination” section of the PR-4 report

You will find the “Physical Examination” section on the second page of the PR-4 report form that’s currently on the California Department of Industrial Relation’s website.

Make sure that you present your measurements clearly so that it’s easy to read for a claims adjuster, employer, or another doctor. Indicate the plane of motion and the side of the measurement.

We like to show our measurements in a table. This is how the new version of RateFast, our PR-4 reporting web app, displays the range of motion of a body part:

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How to Request Authorization for Treatment

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If you are a medical professional working in California workers’ compensation, then you will probably need to prescribe treatment or diagnostic testing for your patients.

When you’re working in California work comp, all treatment, testing, and other medical services must be authorized by the employer’s insurance administrator. To request authorization, you need to submit a Request for Authorization (or RFA). The RFA is a written request for treatment, diagnostic testing or other medical services for the injured worker.

Anybody can fill out a form. But it takes a true professional to complete an RFA form with all the information that insurance administrators need.

If you don’t complete an RFA form correctly, then your treatment authorization may be delayed, or not approved at all.

But you can easily submit a RFA that will give insurance administrators all of the information they need. You just need to cover all the bases by following a few simple steps.

How to Correctly Submit a Complete RFA in 8 Easy Steps

  1. Get the correct RFA form from the DWC website, here: https://www.dir.ca.gov/dwc/DWCPropRegs/IMR/IMRFormRFAClean.pdf

  2. In the top box of the form, check the reason for the RFA.

    • Check “New Request” for all treatment that you have not previously requested.
    • Check “Resubmission – Change in Material Facts” if new information is available about the employee’s medical condition.
    • Check “Expedited Review: Check box if employee faces an imminent and serious threat to his or her health” if the request is urgent–but not life threatening. (If the request is life threatening, and the employee requires hospitalization or emergency surgery, then submit a concurrent RFA.)
    • Check the “Check box if request is a written confirmation of a prior oral request.” if you have spoken with the claims adjuster, and you have agreed that the employee needs care and that the treatment will be approved. For example, if the employee requires immediate surgery or medication, and the adjuster verbally approves the treatment, you will still need to submit an RFA.

     

  3. Complete the rest of the form by providing basic information about the injured worker.

  4. In the “Requested Treatment” section, ensure that you give all details about the treatment you’re requesting in the “Other” column. For example, if you’re requesting physical therapy, then make sure that you indicate the amount of treatments; if you’re prescribing medication, then specify the dosage and refills.

  1. If you’re the treating physician, then sign the RFA. If you’re not the treating physician, make sure you get his or her signature.

  2. Submit the Request For Authorization form with the visit report (the Doctor’s First Report, PR-2 report, etc.) via fax or email. If you don’t submit the RFA with the visit report, then the RFA will likely be returned to you.

  3. You should receive your approved or denied RFA within 14 calendar days after you submit it. If you don’t, then contact the insurance administrator.

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