Mont. Admin. r. 24.29.1513

Current through Register Vol. 23, December 6, 2024

Rule 24.29.1513 - DOCUMENTATION REQUIREMENTS

(1) A treating physician or emergent or urgent care provider must provide the insurer the following documents within seven days of the first claim-related visit:

(a) initial report;

(b) Medical Status Form; and

(c) treatment bill (CMS 1500).

(2) The treating physician must prepare a treatment plan. The treatment plan must be provided to the insurer as soon as possible. The treating physician must provide any changes to the treatment plan to the insurer.

(3) To be eligible for payment, the provider must provide to the insurer:

(a) CMS 1500;

(b) functional improvement status with respect to the treatment plan; and

(c) applicable treatment notes.

(4) Documentation is considered to be a service to the injured worker and no charge is allowed for the documentation required by this rule.

(5) The treating physician must report immediately to the insurer the date total disability ends or the date the injured worker is released to return to work.

Mont. Admin. r. 24.29.1513

NEW, 1993 MAR p. 404, Eff. 4/1/93; AMD, 1994 MAR p. 680, Eff. 4/1/94; AMD, 2013 MAR p. 1185, Eff. 7/12/13; AMD, 2024 MAR p. 1066, Eff. 5/11/2024

AUTH: 39-71-203, MCA; IMP: 39-71-704, MCA