How to Become a Workman's Compensation Provider

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Worker's Compensation is a form of disability insurance paid for by employers and which provides employees with monetary and medical benefits in the event of a disability resulting from a job-related injury or illness. Medical providers may wish to provide medical services to employees receiving worker's compensation benefits. If you are a medical provider wishing to become a Worker's Compensation provider, you should take certain steps.

  • Determine where you will provide medical services. Rules regarding Worker's Compensation providers vary from state to state. Although it is easiest to become approved as a Worker's Compensation provider in only one state, it is possible to become approved in multiple states. Determining the state in which you will provide coverage will tell you which state's application procedures and qualifications you must follow. For a listing of all 50 states' Worker's Compensation Agencies, visit IC.NC.gov (see Resources for link).

  • Review the state's qualifications to see if you qualify to be a provider. Each state has certain standards that a medical provider must meet in order to be classified as a Worker's Compensation provider. The Division of Worker's Compensation for each state provides the list of qualifications that must be met. For example, you may have to be certified first as a general health care provider or gain authorization or approval from a medical network.

  • Fill out an application to become a Worker's Compensation provider. Some states require that you submit an application to the state in order to become a Worker's Compensation provider. Other states require that an application be submitted to the network that you wish to join as a Worker's Compensation provider. The state's Division of Worker's Compensation will provide the necessary application and instructions for whom should receive the submitted application. Regardless of who receives the completed applications, the proper way to file an application is usually via postal mail. This is because of the vast amount of paperwork involved, which is not easily submitted online.

    Some states require a character or competence review in addition to the application. The state's Division of Worker's Compensation will tell you whether this step is required for your state.

  • Meet necessary requirements. There are standards of care for each state that must be obtained to be a Worker's Compensation provider. These standards vary from state to state, but may involve providing periodic reports, complying with certain billing or reporting requirements and disclosing information about claims. Your state's Division of Worker's Compensation and state legal code will set forth these requirements.

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