Oklahoma Provider Request for Medical Fee Dispute Resolution is an administrative process used to resolve disputes between an insurance company and an Oklahoma healthcare provider regarding medical fee reimbursement. This process is governed by the Oklahoma Administrative Code (MAC) and allows providers to submit a dispute resolution request to the Oklahoma Department of Insurance (ODI) for review and resolution. The types of Oklahoma Provider Request for Medical Fee Dispute Resolution are: 1) Prepayment Dispute Resolution and 2) Post-payment Dispute Resolution. Prepayment Dispute Resolution is used to resolve disputes regarding the amount of payment for a medical service prior to the service being provided. Post-payment Dispute Resolution is used to resolve disputes regarding the amount of payment for a medical service after the service has been provided. Both types of dispute resolution requests must include a copy of the medical invoice, documentation of the provider’s patient eligibility, and the provider’s detailed appeal.
Oklahoma Provider Request for Medical Fee Dispute Resolution
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FAQ
The form is listed under Affidavit of Exempt Status on the Case OK website. The cost for an Affidavit of Exempt Status is $50.00 plus a $1.00 online processing fee. Please note the Workers' Compensation Commission will not accept checks for the Affidavit of Exempt Status Fee.
Workers' compensation will not cover pain and suffering. In addition, employees are generally not allowed to sue their employers for workplace accidents.
Therefore, a 5 impairment rating means the victim has suffered injuries affecting at least 5 percent of a particular body part. An impairment rating can also be calculated based on the percentage of the entire body.
Amount: compensation is equal to 70% of the difference between the employee's average weekly wages and the employee's wage-earning capacity in the same employment or otherwise, if less than before the injury. It may not exceed 80% of the employee's average weekly wages at the time of the accident.
Claims forms are on the Commission's website, .wcc.ok.gov. They also are available at both Commission locations, 1915 N. Stiles Avenue, Oklahoma City, OK 73105 and 210 Kerr State Office Building, 440 S. Houston, Tulsa, OK 74127.
To calculate the impairment award, the CE multiplies the percentage points of the impairment rating of the employee's covered illness or illnesses by $2,500.00. For example, if a physician assigns an impairment rating of 40% or 40 points, the CE multiplies 40 by $2,500.00, to equal a $100,000.00 impairment award.
Consider contacting your insurance company to make a First Report of Injury before you file a claim via CC-Form 3. (All Forms submitted to the Commission shall be in black print on white paper. Please do not use colored forms.)
Temporary Total Disability TTD benefits are calculated as 70% of your average weekly wage (AWW) in the year preceding your injury, up to a maximum based on average statewide wages. For injuries that happened in 2022, the maximum TTD benefit is $953.18.