For Medical Providers

• New online lookup: network application status

  Providers who have applied to join L&I’s new medical provider network can now check their application status online.  Simply enter your NPI or L&I Provider ID on the following webpage:

  www.ProviderNetworkStatus.Lni.wa.gov

  Over 15,000 providers to date have applied, and more than half of these have already been approved and enrolled in L&I’s new network. 

  Due to the great response from providers, we are currently working through a very large number of applications. Our turnaround on applications is slower than expected. 

  We are committed to not let delays in our processing interfere with continuity of care for your patients. In the next 1-2 weeks, applications that pass a screening for completeness and key requirements will be shifted to provisional status.

  “Provisional status” lets qualified providers treat and be paid for ongoing care while we complete full review of their network application. A mailing to notify affected providers is coming soon.

  For a list of providers who have been fully approved to join the network, see: www.FindADoc.Lni.wa.gov

  We appreciate your patience during this transition, and thank you for treating injured workers!

• HSA Webinar for Hospitals and ERs - "What Emergency Departments need to know about L&I’s new Provider Network."
• The October roundup of L&I news for providers is now available online. You can also receive updates through our Medical Provider News email list. (October 22, 2012)
• Don't know what drugs are covered?
  Using our new Drug Lookup tool, you can instantly see which drugs are covered under workers’ compensation.  If a drug is non-preferred or requires prior authorization, you can also view formulary alternative(s). This tool will be especially helpful to decrease calls from pharmacies to change to formulary drugs and will decrease workers’ wait time to receive their medication. (July 16, 2012)
• New Missed Appointment Policy - L&I  has developed a new policy that will allow providers to charge an injured worker for a missed appointment. The provider must have a missed appointment policy that applies to all insurers and the provider must notify the injured worker of their missed appointment policy. L&I is not responsible for payment of a missed appointment unless the appointment is for an examination arranged by L&I or self-insurer (e.g. IME).  L&I or self-insurers are not responsible for the implementation and/or enforcement of any providers missed appointment policy. For more information please see WAC 296-20-010. (March 23, 2012)
• New Explanation of Benefits (EOB) Look-up - L&I has created a new look-up utility that will help you determine why a bill has suspended/denied, or provides you with the explanation of payment level made to you.  This tool will be especially helpful to organizations that have separate accounting and billing departments. The look-up utility can be found at: http://www.Lni.wa.gov/ClaimsIns/Providers/Billing/EOB/default.asp (March 20, 2012)
• The July roundup of L&I news for providers is now available online. You can also receive updates through our Medical Provider News email list. (July 17, 2012)
• The May roundup of L&I news for providers is now available online. You can also receive updates through our Medical Provider News email list. (May. 4, 2012)
• The April roundup of L&I news for providers is now available online. You can also receive updates through our Medical Provider News email list. (Apr. 4, 2012)
• The February roundup of L&I news for providers is now available online. You can also receive updates through our Medical Provider News email list. (Feb. 14, 2012)
• Proposed rules have been filed to clarify issues related to an injured worker's first visit to a medical provider following injury or illness. (Feb. 8, 2012)
• Health Advisory on Methadone - Read important safety information on methadone and other opioids. Before prescribing these dangerous drugs, providers need to be knowledgeable about each opioid’s indication, dosing, pharmacology, pharmacokinetics and toxicities. (Jan. 9, 2012)
• Provider Network Rules filed with the Washington State Code Reviser's Office to take effect on February 3, 2012. (Jan. 4, 2012)
  • Adoption (Rule-Making Order CR-103)
  • Adopted Rule Language
• The January roundup of L&I news for providers is now available online. You can also receive updates through our Medical Provider News email list. (Jan. 11, 2012)
• Next meeting of the Provider Network Advisory Group set for January 26, 2012. (Jan. 3, 2012)
• L&I will pilot new scheduling option for independent medical exams (131 KB PDF) (Oct. 13, 2011)
  Individual IME providers can schedule exams directly with L&I using a web-based tool, beginning November 1, 2011.
• Effective January 1, 2012 a new web incentive will be available for ROAs submitted electronically. The full payment policy is available here. (Nov. 8, 2011)
• Proposed Provider Network Rules Filed. Proposed rules have been filed to establish a statewide Medical Provider Network for injured and ill workers.  Three public hearings will be held in December to allow for public comment.  For more information about the proposed rules view the documents here. (Nov. 3, 2011)
• Special Meeting of the Provider Network Advisory Group will be held December 8, 2011, from 1:00 - 5:00 p.m at the SeaTac Airport, Port of Seattle Beijing Room, 17801 International Boulevard, Seattle WA 98158. For the purpose of discussion of draft rules related to the Medical Provider Network. (Oct. 25, 2011)
• Special Meeting of the Provider Network Advisory Group will be held October 27, 2011, from 4:00 - 6:00 p.m at the SeaTac Airport, Port of Seattle Beijing Room, 17801 International Boulevard, Seattle WA 98158. For the purpose of discussion of draft rules related to the Medical Provider Network. (Oct. 25, 2011)
• We now offer electronic adjustment process on your previously processed bill. (Oct. 20, 2011)
• ICD-10 Implementation Plan at L&I While we are working on these, please continue using the ICD-9 for now. (Oct. 20, 2011)
• The Centers of Occupational Health and Education (COHE) are expanding! Come to a public meeting to learn more about how to sponsor a COHE in your community. Beginning Oct. 17, L&I will offer information in six sessions statewide. (Sept. 29, 2011)
• Next meeting of the Provider Network Advisory Group set for October 13, 2011 (Sept. 10, 2011)
• Provider Satisfaction Survey results now available (350 KB PDF) (Aug. 29, 2011)
  974 providers shared their perceptions and concerns about L&I. (Thank you to everyone who participated.) Your feedback will help us create the provider network and continue improving claims management and communications with providers.

• First meeting of the Provider Network Advisory Group set for July 28, 2011 (July 8, 2011)
• Fee Schedule Look up for 2011 (July 1, 2011)
  New and improved medical fee schedule look up function that gives providers important information about billing codes. Included in the function are coverage decisions, prior authorization requirements, and non-facility and facility fees.
• The department has published the 2011 edition of the Medical Aid Rules and Fee Schedules (June 30, 2011)
  Fee schedules are Effective July 1, 2011.
• L&I moves ahead with planning on provider network and COHE expansion (June 17, 2011)
  Learn what the new network could mean to you, and how it and the new COHEs will be developed.
• File accident reports on time to receive the full fee (May 26, 2011)
  Effective July 1, if providers take more than 5 days to file an accident report, L&I will pay less.
• L&I piloting online claim filing in Northwest Washington during 2011
  Online claim filing will be available first in Snohomish, Skagit, Whatcom, San Juan and Island counties.  

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