Chapter 15: Medical Testimony

Billing & Payment Policies for Healthcare Services provided to Injured Workers and Crime Victims

 

 

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Effective July 1, 2011

Complete Chapter for printing

(Republished February 1, 2012)

Look for possible updates and corrections to these payment policies

 

Table of contents

Payment policies:
Medical testimony and depositions

More info:
Related topics


Payment policy: Medical testimony and depositions

Who arranges testimonies and depositions

The Office of the Attorney General or the SIE makes arrangements with expert witnesses to provide testimony or deposition.

Responsibilities of providers

Any provider having examined or treated a worker must:

  • Abide by the fee schedule, and
  • Testify fully, irrespective of whether paid and called to testify by the Office of the Attorney General or the self-insurer.

Link: For more information, see RCW 51.04.050.

Reasonable availability

The Office of the Attorney General or the self-insurer and the provider must cooperate to schedule a reasonable time for the provider’s testimony during business hours.

Providers must make themselves reasonably available for such testimony within the schedule set by the Board of Industrial Insurance Appeals.

Cancellation fees

If the cancellation notice for the testimony or deposition is… Then the Attorney General/SIE:
3 working days or less than 3 working days before a hearing or deposition Will pay a cancellation fee for the amount of time you were scheduled to testify, at the allowable rate.
More than 3 working days before a hearing or deposition Won’t pay a cancellation fee.

Services that can be billed

The Office of the Attorney General provides a medical provider testimony fee schedule when testimony is scheduled.  The medical witness fee schedule (see below) is set by law.

Note: In the fee schedule below, 1 unit equals 15 minutes of actual time spent.

Fee schedule for testimony and related fees, effective July 1, 2011:

If the service provided by a doctor is… Then the maximum fee is:
Medical testimony (live or by deposition) $100.00/unit*
(maximum of 17 units)
Record review $100.00/unit*
(maximum of 25 units)
Conferences (live or by telephone) $100.00/unit*
(maximum of 9 units)
Travel
(paid on a portal to portal basis, which is from the time you leave your office until you return, but not to include side trips)
$100.00/unit*
(maximum of 17 units)
If the service provided by all other healthcare providers is… Then the maximum fee is:
Medical testimony (live or by deposition) $22.50/unit*
(maximum of 17 units)
Record review $22.50/unit*
(maximum of 25 units)
Conferences (live or by telephone) $22.50/unit*
(maximum of 9 units)
Travel
(paid on a portal to portal basis, which is from the time you leave your office until you return, but not to include side trips)
$22.50/unit*
(maximum of 17 units)
If the service provided by a vocational provider is… Then the maximum fee is:
Medical testimony (live or by deposition), regular vocational services
Medical testimony (live or by deposition), forensic vocational services
$22.50/unit*
$26.25/unit*
(maximum of 17 units)
Record review, regular vocational services
Record review, regular vocational services, forensic vocational services
$22.50/unit*
$26.25/unit*
(maximum of 25 units)
Conferences (live or by telephone), regular vocational services
Conferences (live or by telephone), forensic vocational services
$22.50/unit*
$26.25/unit*
(maximum of 9 units)
Travel, regular vocational services
Travel, forensic vocational services
(paid on a portal to portal basis, which is from the time you leave your office until you return, but not to include side trips)
$22.50/unit*
$26.25/unit*
(maximum of 17 units)
If the service provided by an out of state doctor is… Then the maximum fee is:
Medical testimony (live or by deposition) $125.00/unit*
(maximum of 17 units)
Record review $125.00/unit*
(maximum of 25 units)
Conferences (live or by telephone) $125.00/unit*
(maximum of 9 units)
Travel
(paid on a portal to portal basis, which is from the time you leave your office until you return, but not to include side trips)
$125.00/unit*
(maximum of 17 units)

Link: For legal definitions of “doctors” and “out of state doctors,” see WAC 296-20-01002.

Services that aren’t covered

Requests for a nonrefundable amount will be denied.

Requirements for billing

For State Fund claims:

  • Providers shouldn’t use the CPT® code 99075 to bill for these services, and
  • Bills for these services should be submitted directly to the Office of the Attorney General.

Note: State Fund utilizes a separate voucher “A19” form, which will be provided to you by the Office of the Attorney General.

For self-insured employer claims:

  • SIEs must allow providers to use CPT® code 99075 to bill for these services, and
  • Bills for these services should be submitted directly to the SIE/TPA.

Payment limits

Prepayment

L&I can’t provide prepayment for any of these services.

Calculating timed fees

Travel fees are calculated:

  • On a portal to portal time basis (from the time you leave your office until you return), and
  • Don’t include side trips.

The time calculation for testimony, deposition, or related work performed in the provider’s office or by phone is based upon the actual time used for the testimony or deposition.

Interpretive services

The party requesting interpretive services for depositions or testimony is responsible for payment.


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If you’re looking for more information about… Then go here:
Administrative rules for definitions Washington Administrative Code (WAC) 296-20-01002:
http://apps.leg.wa.gov/wac/default.aspx?cite=296-20-01002
Becoming an L&I provider L&I’s website:
www.Lni.wa.gov/ClaimsIns/Providers/Becoming/default.asp
Billing instructions and forms Chapter 1:
Introduction
Fee schedules for all healthcare services L&I’s website:
http://feeschedules.Lni.wa.gov
Legal statute (Washington state law) for physician or licensed advanced registered nurse practitioner’s testimony not privileged Revised Code of Washington (RCW) 51.04.050:
http://apps.leg.wa.gov/RCW/default.aspx?cite=51.04.050

Need more help?  Call L&I’s Provider Hotline at 1-800-848-0811.


 

CPT® codes and descriptions only are © 2010 American Medical Association

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