Site Alert

Claim & Account Center and Secure Message Center are currently experiencing intermittent slowdowns. We are working to resolve this issue as soon as possible. We apologize for any inconvenience.

Orthopedic and Neurological Surgeon Quality Project

Self-Insured Employers Participating

L&I developed this project to help injured workers rehabilitate promptly by improving access to high quality surgical care. Because self-insured employers are responsible for the workers compensation benefits of one-third of Washington’s workforce, it’s important to have self-insurance participation. Participation in the project is voluntary. The project requirements and fee schedule are not in effect for self-insured injured workers unless the employer has registered to participate.

What are the benefits of participating?

  • Improved access to orthopedic and neurological surgeons for your employees.
  • More consistent information to manage claims (Activity Prescription Form).
  • Improved coordination of care.
  • Increased availability of work activity (restriction) information.

What are the costs?

  • L&I estimates an additional $300, on average, of payment per injured worker receiving care from a project surgeon (including payment for APF and incentive pay).
    • NOTE: This additional cost may be offset by a decrease in time loss payments. The University of Washington will evaluate the project to find out the effects of the project.
  • Participating providers may bill and be paid a quality indicator incentive payment each time they complete and bill for an APF:
    • Amount of incentive pay depends on the provider’s tier assignment.
    • Tier assignments are based on provider meeting thresholds for specific indicators of quality care.
  • There is no fee to register as a participant.

Which self-insured employers are currently participating in the project?

  • Clark County
  • Clark County PUD #1
  • RSG Forest Products
  • Peace Health
  • WinCo Holdings
  • Walmart
  • Vancouver Public School Dist. #37
  • Legacy Health
  • ESD 112
  • City of Vancouver
  • City of Longview
  • Safeway
last updated June 8, 2017

If you would like to contact one of the self-insured employers please visit: http://Lni.wa.gov/ClaimsIns/Insurance/SelfInsure/EmpList/FindEmps/Default.asp

 

How do I participate as a Self-Insured Employer for the project or obtain more information?

End of main content, page footer follows.

Access Washington official state portal

  © Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.

Help us improve