New ICBC regulations that changed support for patients injured in motor vehicle accidents came into effect on April 1, 2019. For physicians, these changes also included eliminating the CL19 and introducing new forms and payments.
Now that those changes have been in effect for six months, Doctors of BC is providing members an update as well as answers for two frequently asked questions.
Since April 1, 2019 the following number of reports have been completed by physicians:
It is important to remember that family physicians are only expected to complete one Standard or Extended report per ICBC claim, except in more complex recovery cases that may require a Reassessment Report. More information on reports can be found here.
We are also aware that there is a billing issue regarding rejections of the 13075 fee. Doctors of BC has escalated this problem to both the Medical Services Plan and ICBC, and they are working on an interim and long-term solution. We will inform members immediately when we have an update.
1. What is the Registered Care Advisor (RCA) referral process?
Six months following the April 1 changes to Accident Benefits at ICBC, the Registered Care Advisor (RCA) remains a little known resource supporting family physicians. The RCA may be either a specialist or family physician with a focused practice. The RCA Information Guide is a helpful resource for referring physicians and those fulfilling the RCA role. Take a few minutes and review the guide, with special attention to the referral process:
o They are unable to make a clear diagnosis,
o The patient is not recovering as expected by the physician, or
o There are factors complicating the patient’s recovery from the injury.
The physician selects a Registered Care Advisor from the roster, according to their location, specialty and/or availability.
The physician’s support staff or Medical Office Assistant (MOA) make the referral following the same process they would for any Specialist referral, providing appropriate information, including the Reassessment Report if completed.
You can find additional ICBC resources and information here.
2. Do ICBC Reports include an office visit fee?
The initial report includes the office visit fee. You should not bill a separate office visit.
For appointments needing a Reassessment Report, the report serves as the invoice and includes the office visit fee. You should not bill a separate office visit.
Ask the injured person if the claim is still open for all appointments related to crash injuries.
Once the claim is closed, billing reverts to regular MSP.
In October, the B.C. Supreme Court deemed it unconstitutional to limit the number of expert reports during trial. While the decision does not directly impact doctors, some may get more requests to be medical experts in upcoming cases.
In a second case, trial lawyers are also challenging the $5,500 cap on pain and suffering claims for minor injuries, and the decision to have claims under $50,000 reviewed by the Civil Resolution Tribunal.