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Washington Notice of Independent Medical Exam No-Show or Late Cancellation

State:
Washington
Control #:
WA-SKU-3749
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PDF
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Notice of Independent Medical Exam No-Show or Late Cancellation
The Washington Notice of Independent Medical Exam No-Show or Late Cancellation is a form required by Washington State law when a patient fails to appear or cancels an Independent Medical Exam (IME) less than 24 hours before the scheduled appointment time. The notice is used to document the patient’s failure to comply with the regulations related to IME appointments. There are two types of Washington Notice of IME No-Show or Late Cancellation: one for no-shows and one for late cancellations. The no-show notice is used when a patient fails to appear for an IME at the scheduled time, and the late cancellation notice is used when the patient cancels the appointment less than 24 hours in advance. Both notices must include the patient’s name, date of the scheduled exam, and the date of the no-show or late cancellation. The notices must be signed by the patient and returned to the provider within 30 days of the no-show or late cancellation. Failure to return the notice may result in the patient being responsible for the costs associated with the no-show or late cancellation.

The Washington Notice of Independent Medical Exam No-Show or Late Cancellation is a form required by Washington State law when a patient fails to appear or cancels an Independent Medical Exam (IME) less than 24 hours before the scheduled appointment time. The notice is used to document the patient’s failure to comply with the regulations related to IME appointments. There are two types of Washington Notice of IME No-Show or Late Cancellation: one for no-shows and one for late cancellations. The no-show notice is used when a patient fails to appear for an IME at the scheduled time, and the late cancellation notice is used when the patient cancels the appointment less than 24 hours in advance. Both notices must include the patient’s name, date of the scheduled exam, and the date of the no-show or late cancellation. The notices must be signed by the patient and returned to the provider within 30 days of the no-show or late cancellation. Failure to return the notice may result in the patient being responsible for the costs associated with the no-show or late cancellation.

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FAQ

CPT codes 99455 and 99456 are both designated to cover work-related or medical disability exams. The first covers an exam provided by the treating physician, and the second covers an exam provided by someone other than the treating physician.

An independent medical examination (IME) is an objective medical-legal examination requested (by L&I or self-insurer) to establish medical findings, opinions, and conclusions about a worker's physical condition. These examinations may only be conducted by L&I-approved examiners.

Two well-known acronyms for health plans and payers are IME, otherwise known as independent medical examination, and IMR, or independent medical review.

Codes 99358 and 99359 are used for non-face-to-face prolonged services by the billing physician/NP/PA when provided in relation to an E/M service on the same or different day as an E/M service.

CPT® 99080, Under Miscellaneous Medicine Services. The Current Procedural Terminology (CPT®) code 99080 as maintained by American Medical Association, is a medical procedural code under the range - Miscellaneous Medicine Services.

CPT® Code 99450 - Basic Life and/or Disability Evaluation Services - Codify by AAPC.

Independent Medical Exams will only be paid utilizing these CPT codes: o CPT 99455- IME by Treating Physician- Includes 30 minutes of record review time. o CPT 99456- Summary of Notes by Non-Treating Physician- Includes 30 minutes of record review time.

More info

A: No, the department will not reimburse the employer for the late cancellation fee. Q: Does an addendum to an IME count as a second IME?It will only delay your claim further. We can give you an estimate of the fee for an upcoming evaluation based on this information. If it is necessary to cancel an appointment, patients are required to call or leave a message at least 24 hours before their appointment time. It is very important that you call within 24 hours in advance to cancel your appointment. Program. The Division Independent Medical Examination. The Medical Unit also issues QME panels to injured workers and claims administrators. Fill Out The Notice Of Independent Medical Exam No-show Or Late Cancellation - Washington Online And Print It Out For Free. (noshows).

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Washington Notice of Independent Medical Exam No-Show or Late Cancellation