Reporting timelines

Dr. Rick Ward

Need to know about the difference between submitting same day, on time or late reports? The Agreement improves the timing and efficiency of the exchange of information that is important and unique to these patients/workers. The 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 on the following business day.

Note: “Business Day” is defined as Monday through Friday from 00:00:00 to 23:59:59 MST each day, excluding the Employment Standards Code of Alberta designated holidays: New Year’s Day, Alberta Family Day, Good Friday, Victoria Monday, Canada Day, Labour Day, Thanksgiving Day, Remembrance Day, Christmas Day, Boxing Day and August 1 civic holiday).
“Examination Date” = day 0

  • Scenario A: Patient registers at 11:00 Monday. Physician sees patient and completes examination at 1300 Monday. For same day status, WCB needs to receive the report by 10:00 Tuesday.
  • Scenario B: Patient registers at 23:30 Friday. Physician sees patient and completes the examination at 02:00 Saturday. For same day status, WCB needs to receive the report by 10:00 Monday.

On time report submission

GP First Report – The report is received by the WCB within three (3) business days from the date of the completed examination, including up to 10:00 on the fourth (4) business day.

GP Progress 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 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 on the fifth (5) business day.

  • Scenario: Patient registers at 19:00 Tuesday. Specialist sees patient and completes the examination at 22:00 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 the following Tuesday.

Late report submission

A report is considered late if it is received by WCB after the on time reporting schedule 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.

First Report

The WCB First Report fee is paid to a physician the first time that 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;”

The Alberta Medical Association stands as an advocate for its physician members, providing leadership & support for their role in the provision of quality health care.