WAC 296-23-302 Definitions. Approved independent medical examination (IME) provider - A doctor or firm whose credentials are approved to conduct an independent medical examination, rating evaluation, or provide IME associated services including but not limited to file preparation, scheduling of examinations and processing billing. An approved IME provider is assigned a unique provider number.

аааа Department - For the purpose of this section, department means the department of labor and industries industrial insurance workers' compensation state fund and self-insured programs.

аааа Direct patient care - For the purpose of meeting the qualifications of an independent medical examination (IME) provider, direct patient care means face-to-face contact with the patient for the purpose of evaluation and management of care that includes, but is not limited to:

аааа Х History taking and review of systems;

аааа Х Physical examination;

аааа Х Medical decision making;

аааа Х Coordination of care with other providers and agencies.

аааа This does not include time spent in independent medical examinations.

аааа Impairment rating examination - An examination to determine whether or not the injured/ill worker has any permanent impairment(s) as a result of the industrial injury or illness after the worker has reached maximum medical improvement. An impairment rating may be conducted by a qualified attending provider, a medical consultant, or an approved examiner. An impairment rating may be a component of an IME.

аааа Independent medical examination (IME) - An objective medical-legal examination requested (by the department or self-insurer) to establish medical facts about a worker's physical condition. These examinations may only be conducted by department-approved examiners.

аааа Independent medical examination (IME) provider - A firm, partnership, corporation, or individual doctor (examiner) who has been approved and given an independent medical examination (IME) provider number by the department to perform IMEs.

аааа Medical director - A licensed doctor in the firm, partnership, corporation or other legal entity responsible to provide oversight on quality of independent medical examinations, impairment ratings and reports.

аааа Medical Examiners' Handbook - A handbook distributed by the department containing department policy and information to assist providers who perform independent medical examinations and impairment rating examinations.

аааа Patient related services - Patient related services are defined as one or more of the following professional activities:

аааа Х Direct patient care;

аааа Х Locum tenens;

аааа Х Clinical consultations for treating/attending doctors;

аааа Х Clinical or classroom instruction of medical, osteopathic, dental, podiatry, or chiropractic students and/or residents;

аааа Х On-call emergency services;

аааа Х Volunteer clinician providing patient care services in his or her specialty;

аааа Х Participation in clinically based peer review or quality review activities.

аааа Provider number - A unique number(s) assigned to a provider by the department of labor and industries. The number identifies the provider and is linked to a tax identification number that has been designated by the provider for payment purposes. A provider may have more than one provider number assigned by the department.

аааа Suspension - A department action during which the provider is approved by the department but not available to accept referrals.

аааа Temporarily unavailable - Provider is approved by the department but is temporarily unavailable to accept referrals. Temporarily unavailable applies at the provider's request for personal reasons or by the department as part of an administrative action. Provider remains unavailable until the issue is resolved.

аааа Termination - The permanent removal of a provider from the list of approved IME examiners. All IME provider numbers assigned to the examiner are inactivated.

[Statutory Authority: RCW 51.32.055, 51,32,112 [51.32.112],51.32.114 , 51.36.060, and 51.36.070. 09-24-085, з 296-23-302, filed 11/30/09, effective 3/1/10; 04-04-029, з 296-23-302, filed 1/27/04, effective 3/1/04.]