Medical Fee Services eNews
Q3
2023
Virginia Workers' Compensation Commission
Regulatory Focus
65.2-605 (F.1) The Commission shall provide public access to information regarding the Virginia fee schedules for medical services, by categories of providers of fee scheduled medical services and for each medical community, through the Commission's website.
Greetings from the Manager
The Medical Fee Services Department had its beginnings in early 2017, in direct response to legislation to bring a medical fee schedule to the Virginia Workers’ Compensation system. One of the department’s roles is the administration of the schedules, which involves the receipt, review, and analysis of large amounts of information to make informed recommendations for fee schedule updates and resolve medical fee schedule disputes. Six years later, the department is now in the final phases of completing the third revision to the schedules and this year’s review like those in the past, has created opportunities to learn more about our system stakeholders and their concerns and provide public access to information and responses that are geared toward education and outreach for the Virginia fee schedules as well as improved understanding of the role of the Commission.
This quarterly newsletter highlights three key methods for public access to current opportunities, resources, and events for the Virginia fee schedules:
Training provided by the Medical Fee Services Department.
Commission planned enhancements to the Medical Fee Schedule Lookup tool.
Opportunity for engagement at The 1st MFS Symposium during the VWC Educational Conference
Training Opportunities
Topics below are available in person or virtually.
Understanding the Nuts and Bolts of the Medical Fee Schedules
- Provide a comprehensive review of the MFS Regulations
- Introduce the Roles and responsibilities of the Commission and Regulatory Advisory Panel
- Explore key MFS schedule data elements
- Explain the role of The Ground Rules
Impacts and Influences of the Medical Fee Schedules
- Clarify Implications for Providers and Payers
- Illustrate the MFS review and maintenance of schedules
Medical Fee Schedule Dispute Resolution
- Review Forms and Notices
- Give examples of required documentation
- Provide examples of key applicable coding conventions
- Discuss MFS Exclusions and dispute resolution
Breaking down the Administrative Determination
- Review the importance of supporting medical records
- Explore the administrative decision components
- Discuss the process to appeal the decision
Medical Provider Inquiry Forms
- Review the importance of supporting medical records
- Explore the administrative decision components
- Discuss the process to appeal the decision
Do you have new staff?
Would you like an overview of the medical fee schedules?
Please send your request to: medicalfeeservices@workcomp.virginia.gov
October 18, 2023
New for the 2023 VWC Educational Conference, the Medical Fee Services Department will hold its first MFS Symposium.
(registration is free for all attendees).
Interested in attending the 2023 MFS Symposium?
Let us know here.
MFS Opportunities
2024 Biennial Review of the Medical Fee Schedule – For a complete listing of activities, please review the timeline on the Commission website.
Upcoming Events |
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