FOR TREATMENT REQUESTS

For the past 20 years, the Workers’ Compensation Board has been slowly moving from a paper-based system to one that is technology-based. Earlier this year, it took a big step in that process by launching a program it calls “OnBoard Limited Release.”

Until recently, doctors and other health care provider were required to submit requests for authorization on a paper form, usually an “MG-2” or “C-4AUTH” form. The forms had to be submitted to the Board and the insurance carrier by fax (and later by email), and failure to submit them properly would result in denial of the request.

As of May 2, 2022, providers must register for the Board’s new “Medical Portal” and submit any requests for treatment, prescription medication, and medical devices online. This new process seems to have streamlined the process for providers, resulted in quicker response times and avoided automatic denials due to improper submission. However, to use the new system doctors have had to change their office procedures and learn how to use the new online submission process – the Board no longer accepts the paper submission of authorization or treatment requests.

An important part of the Medical Portal process is that in most cases it is the treating doctor – not the patient or the patient’s lawyer – that must file for review of an insurer’s denial. There are Level 1, Level 2, and Level 3 requests and unless the denial is based on a legal issue in the case, the Board will not schedule a hearing to address the denial until all the treating doctor has exhausted all three levels of review.