Need to know about the difference between submitting same day, on time or late reports?. The AMA-WCB Physician Services Compensation Agreement applies incentives for same day and on time reporting that can reduce turnaround times for WCB patients to receive care and return to work when they are healthy again.
Definitions
Same day report (GP or Specialist) submission
The report is received by WCB on the same day as the completed examination, including up to 10:00 Mountain Time (MT) on the following business day.
Note: “Business Day” is defined as Monday through Friday from 00:00:00 MT to 23:59:59 MT each day, excluding the Employment Standards Code of Alberta designated holidays: New Year’s Day, Alberta Family Day, Good Friday, Victoria Monday, Canada Day, August Civic Holiday, Labour Day, Thanksgiving Day, Remembrance Day, Christmas Day, Boxing Day and.
“Examination Date” = day 0
- Scenario A Community Practice:. Physician sees patient and completes examination at 13:00 MT Monday. For same day status, WCB needs to receive the report by 10:00 Tuesday.
- Scenario B Emergency Department: Patient registers at 23:30 MT Friday. Physician sees patient and completes the examination at 02:00 MT Saturday. For same day status, WCB needs to receive the report by 10:00 MT Monday.
On time report submission
GP First Report: The report is received by the WCB within three (3) business days of the date of the completed examination, including up to 10:00 MT on the fourth (4) business day.
GP Progress Report: The report is received by the WCB within four (4) business days of the date of the completed examination, including up to 10:00 MT on the fifth (5) business day.
Specialist Consultation Report/Specialist Follow-up Report: The report is received by the WCB within four (4) business days from the date of the completed examination, including up to 10:00 MT on the fifth (5) business day.
- Scenario Emergency Department: Patient registers at 19:00 MT Tuesday. Specialist sees patient and completes the examination at 22:00 MT Tuesday. In order for this Specialist Consultation/Specialist Follow-up report to be classified as an on time report submission, WCB must receive the report by 10:00 MT the following Tuesday.
Late report submission
A report is considered late if it is received by WCB after the on time reporting timeframe applicable to the type of report: GP First Report, GP Progress Report or Specialist Consultation/Follow-up Report.
Receiving vs. Submitting
It’s important to note that a “same day or on time report submission” refers to the time when WCB receives a report and does not refer to the time the report is submitted. If you are submitting reports through your EMR rather than myWCB, there may be a delay in transmitting the report to WCB.
If there is an error or outage with myWCB or Rapid Report, report fees will be determined based on the submission date and time, rather than on the processed date and time. This will ensure that report submissions are paid accurately, even if myWCB is experiencing an outage (scheduled or unscheduled).
In the event of an internal error with myWCB or Rapid Report, WCB will honour the higher differential report fee as is their historical practice.
WCB will also accept an Emergency Department report from ConnectCare as proof of same-day or on-time report, if myWCB is experiencing an outage.
First Report
The WCB First Report fee is paid to a physician the first time that individual physician sees the worker for that work-related injury. The contract uses the term “first visit” but defines it as follows:
“’First Visit’ means the first occasion that a Physician provides medical aid and reporting arising from a specific work-related accident, regardless of whether the Worker has previously been seen by another Physician for the same accident;”