The Hand & Wrist Center welcomes workers’ compensation injuries involving the upper extremities. We realize the importance of finding a balance between excellent patient care and cost-efficiency. In addition, we acknowledge the significant value in timely medical-information reporting, patient-claim processing, and reducing long-term disability factors.
Please be advised that it is our Center’s Financial Policy that all patients have the proper authorization prior to the initial consultation. This authorization should be specified to the type of consultation required, in addition to the requested treatment. Furthermore, this authorization is required in writing and must be received by our office prior to services being rendered. In order to continue the delivery of timely and quality service(s), please assist our Center in obtaining the proper authorization required to ensure payment for our services.
Our services include the following consultations types (*note that each consultation type may or may not require radiologic evaluation, and/or further diagnostic testing):
- Consultation Only: Evaluation by a physician including a complete medical history, diagnosis determination, and outlining a treatment plan.
- Consultation and Treatment: Evaluation by a physician including a complete medical history, diagnosis determination, outlining and initiating a treatment plan; the physician assumes the Primary Treating Physician role.
- Surgical Consultation and Treatment: Evaluation by a physician including a complete medical history, diagnosis determination, outlining and initiating a treatment plan; physician assumes primary responsibility for surgical care, but does not assume the Primary Treating Physician role.
- Second Opinion: Evaluation by the physician for purposes of providing a patient/examinee with an additional medical opinion regarding a specific medical condition – including a complete medical history, diagnosis determination, and outlining a treatment plan in comparison, or contrast, to the opinion of another physician.
- Qualified Medical Examination: Please visit the California Department of Industrial Relations for a detailed description.
Patients
- If you have been injured at work, you must file a report with your immediate supervisor or human resource/personnel department so that they may file the appropriate claim paperwork to their Workers’ Compensation insurance carrier. Due to our office’s specialist services category, prior to your initial visit you must receive the appropriate authorization granted by the insurance carrier.
- In emergency cases, your employer is required by State of California Law, to provide you with emergency care. In the event that you require emergency specialist services, our office may provide services to you; however, your employer must contact our office to make these arrangements beforehand.
- Please be advised that we CANNOT see injured workers on a cash-payment basis. All claims must be appropriately reported to an insurance carrier, unless the employer is self-insured.
- If your employer is self-insured, they may have the ability to expedite your referral to our office since they have more administrative control. Please see your employer for more information.
Employers
- If you have injured an employee, in accordance with State of California Law, you must file a formal workers’ compensation claim with your insurance carrier. Proper authorization is required for treatment in any medical facility, especially for providers that render specialty treatment. Authorization can not be obtained by providers until a claim has been established with the carrier. Therefore, the sooner you file a claim, the sooner we will be able to verify benefits with your workers’ compensation insurance carrier and provide treatment to your employee.
- In the event of a significant emergency, your company may contact our office to make arrangements for us to see your employee during your injury-reporting period. For further inquiry regarding this, please review theEmployer’s Promissory Note and contact our office as soon as possible.
- If your company is self-insured as legally recognized by the State of California – Division of Workers’ Compensation, please have your company representative contact our office for patient processing.
Insurance Carriers
- Please review our Authorization Form – Workers’ Comp nd contact our office to process a patient. We appreciate your assistance in providing our office with the necessary information and authorizations that will enable us to expedite our services. Please be advised that we are unable to evaluate patients without the proper documentation and authorization.
- Other form links: Forms for New Patients
Medical-Legal Evaluations
ML-101 Follow-up Medical-Legal Evaluation (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-102 Basic Comprehensive Medical-Legal Evaluation (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-103 Complex Comprehensive Medical-Legal Evaluation (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-104 Comprehensive Medical-Legal Evaluation involving Extraordinary Circumstances (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-105 Medical-Legal Testimony (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-106 Supplemental Medical-Legal Evaluation/Report (See Title 8, California Code of Regulations) (Sections 9793, 9795)
AOE-COE (Arising Out of Employment / in the Course of Employment) (performed upon the request by the employer and/or insurance carrier to address causation factors – i.e. determining if a condition is “work-related”)