- Impairment Rating Information: Worksheets and resources for performing impairment rating reports
- Medical Treatment Guidelines: In-text references and bibliographies
- Rule 5-5: Requires that the necessary impairment rating worksheets, a WC 164 form and a narrative report be submitted to the insurer when indemnity and/or an impairment rating is involved in the closing of a case
- Rule 8: Authorized treating physician (ATP) treatment information including the definition of an ATP, change of the authorized treating physician and independent medical examinations
- HIPAA Information/Release of Medical Record Information: By providers and payers
- Use of Nurse Practitioners and Physician Assistants in the workers' compensation system
- Exercising Independent Medical Judgment in Workers' Compensation
- Audio Recordings of IMEs: Answers to frequently asked questions regarding the audio recording of IMEs
Forms
Commonly used Division of Workers' Compensation Forms for Medical Providers:
- Physician's Report of Workers' Compensation Injury (WC 164): WC 164: Must be used at the opening and closing of the case, and when a change of work restrictions occurs. The authorized treating physician must sign the WC 164 form even when the form is completed by an accredited or not accredited mid-level provider.
- Pre-authorization Form (WC 188): This form is required when the treatment falls outside the medical treatment guidelines. If the treatment is within the guidelines, use the WC 195 form as explained below.
- Notification by an Authorized Treating Provider (WC 195): Providers may submit this form when the treatment is medically necessary, is consistent with the Medical Treatment Guidelines, and has an established value under the Medical Fee Schedule. If the insurer does not respond within 5 days, payment for treatment is ensured.
- Medical Dispute Resolution (WC 181): If a dispute regarding billing, payment, or prior authorization arises, the provider may submit this form to the Division for resolution.
- Discharge for Non-Medical Reasons (Desk Aid 15): If discharging a patient for non-medical reasons a certified letter must be sent to the patient and the insurer. This provides instructions for when to send a certified letter and also includes a templated letter that may be used. Patient Non-Compliance Information.
Contact Us
Provider Education
633 17th Street, Suite 400
Denver, CO 80202
303-318-8754
303-318-8653 (Fax)
cdle_dowc_provider_education@state.co.us