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SCWCC News and Medical Services FAQs

J. Steven Rodenberg

Sandee Sprang was appointed Interim Executive Director by the Commission on October 12, 2020. Ms. Sprang will serve in this capacity during Executive Director Gary Cannon’s convalescence. Please carbon copy Ms. Sprang on all communications to Mr. Cannon during this interim period to ensure requests are properly handled. Ms. Sprang’s contact information is ssprang@wcc.sc.gov; 803-737-5744. The assistant to the Executive Director is Amy Proveaux, aproveaux@wcc.sc.gov; 803-737-5744.

Any appropriately licensed medical provider who is authorized by the employer or insurance carrier may treat workers’ compensation claimants. The Medical Services Provider Manual (MSPM) outlines billing and payment policy for physicians and other healthcare professionals and provides the current schedule of fees. The Fee Schedule does not cover hospital charges, general dental, or services rendered outside of South Carolina.

Medical providers must receive authorization from the employer or insurance carrier prior to providing treatment except for emergency care when the carrier cannot be reached. An employer who authorizes treatment, whether verbally or in writing, enters into a contract with the provider and is responsible for paying for that service, even if it is determined later that the injury was not work-related. When giving authorization, every effort should be made to verify as specifically as possible what services are being authorized. Whenever possible, services should be approved by CPT codes.

By South Carolina Law, payment to a medical provider must be made within 30 days of the tender of the payment request to the employer’s representative.

Deposition testimony is Code 99072 ($400.00) for the initial hour and Code 99073 ($100.00) to report each additional quarter hour. Time is measured based on the actual time spent in the deposition.

IMEs conducted on or after December 15, 2009 will not be subject to a maximum allowable payment.

Payment is $70.00 for completing the Commission’s Form 14B. Pre-payment for the Form or report completion is prohibited. The purpose of the WCC Form 14B Physician’s Statement is to consolidate medical information already existing in the patient’s medical file onto a single, easily referenced document. The Form 14B is a summary of information generated from the patient’s previous medical exams, including the diagnosis, date of maximum medical improvement, permanent impairment, work restrictions, retained hardware, and need for future medical care and treatment.

As always, all of us here at YCRLAW remain available to answer any questions you may have regarding any issues with your workers’ compensation claims.  Feel free to contact us.