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Referrals for treatment

Because I am experienced in treating chronic pain, I see a limited number of individuals with workers compensation insurance. I find that people who have had industrial injuries take a great deal of time to care for. Recent changes in how this insurance works in California have led me to limit new referrals to those whose carriers agree to pay usual and customary fees -- as with all of our patients, no discounts. The claims adjustor must agree in writing to usual and customary fees before the patient will be seen.

Then I'll see the patient for an initial consultation and submit a report recommending a specific course of treatment. If approved by the insurance carrier, I'll begin treatment.

Qualified Medical Examinations

Until 2008 I was a QME (Qualified Medical Evaluator) for the State of California, seeing patients for comprehensive medical-legal assessments. Although I accepted the state-mandated QME fee schedule, many industrial carriers wouldn't pay the legally required fee or required months of hectoring before reimbursing for my services. Too many industrial insurance companies have broken too many promises to me and engaged in too much bad faith for me to want to continue in this role.

Last updated Thu, Oct 1, 2009

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