Welcome to workers' compensation
The Workers’ Compensation Division (WCD) welcomes you to our community. Health care providers play an integral role in the workers’ compensation system, and we’re here to help you to learn what you need to know in order to do the following:
- Understand and follow our rules
- Understand and follow the parameters of providing medical treatment to workers’ compensation patients
- File a dispute if you disagree with an insurer’s decision
- Get paid timely and accurately for your services
The WCD Health Care Provider webpages have many useful tools and resources. You can sign up to receive email notifications on rule changes, industry notices, new information, and more. We never share your email and we only send necessary information that helps you.
Chiropractic physicians, naturopathic physicians, nurse practitioners, and physician assistants must certify to the director of the Department of Consumer and Business Services that they have reviewed and read certain informational material provided by the Workers’ Compensation Division, before they treat any patients with Oregon workers’ compensation claims.
If you have not certified to the director and you treat a patient with an Oregon workers’ compensation claim, the insurer will not have to pay you for the services you provided.
WCD has eight provider-specific handbooks to help you become familiar with workers’ compensation requirements, responsibilities and treatment limitations specific to provider type, and help you to follow the rules when treating workers’ compensation patients. The handbooks do not replace the Oregon Administrative Rules, but they are a valuable resource for both new and experienced providers. You can find your handbook located on the right-side of this webpage.
Oregon Administrative Rules
There are four divisions of Oregon administrative rules that pertain to health care providers:
Are you new to treating workers’ compensation patients and need a basic overview of our terms, concepts, and what makes workers’ compensation different? We have a webinar to get you started called Providers Introduction to Workers’ Compensation. We also offer medical billing and payment webinars after you know the basics. Each medical billing and payment webinar is tailored to a specific provider type. Check out our upcoming trainings webpage and mark your calendar because space is limited. You can register for our lunch-hour webinars or view a recorded webinar training.
Matrix for health care providers
The matrix provides treatment parameters by provider type. This one page reference sheet is designed to quickly answer your questions about who can do what and for how long.
Filing a dispute
If you disagree with an insurer’s decision regarding payment (EOB) or other medical issues, we are here to help. Keep in mind you only have 90 days from the date of the insurer’s decision to request our help in resolving the issue. You can download Form 2842, complete it, and send it to us as well as the other involved parties.
For claims enrolled in a managed care organization (MCO), billing or treatment disputes must go to the MCO within 30 days of the mailing date of the initial MCO decision before the worker may request WCD for administrative review.