Ohio BWC Implements New C-9 Rule
Effective July 25, 2011, Ohio BWC has implemented a new process that permits physical therapists with individual provider numbers to directly submit C-9 requests for therapy services, rather than having to rely on claimants' physician's to submit requests on their behalf. The new rule 4123-6-16.2 states that "Medical treatment reimbursement requests submitted by a physical therapist or occupational therapist must be accompanied by a prescription as required in paragraph (B) of rule 4123-6-30 of the Administrative Code, and approval of such requests shall be valid for no longer than thirty days unless the approval specifies a longer period and such longer period is supported by the prescription." This rule was implemented by Ohio BWC in response to feedback from physical and occupational therapists about semantics confusion and access barriers that resulted from making physicians responsible for submitting treatment requests on behalf of other servicing treatment providers such as physical therapists.
Follow-up that that led to this rule was initiated in response to recommendations from a 2008 multi-stakeholder 60 Summits Leadership Conference to prevent needless work disability of Ohioans. The Ohio Physical Therapy Association (OPTA) was a sponsor of this 60 Summits event and has continued to collaborate with Ohio BWC on this rule and other initiatives to remove access barriers to cost-effective physical therapy providers. The C-9 Rule 4123-6-16.2 may be accessed from the link: http://www.registerofohio.state.oh.us/pdfs/4123/0/6/4123-6-16$2_PH_FF_A_RU_20110711_1411.pdf
This rule promotes autonomy and reduces access barriers to cost-effective PT professionals by:
- Allowing the actual servicing provider to directly submit treatment requests for their own services and thus avoiding unnecessary delays, semantics confusion or reimbursement problems created when the physician specifies the wrong services, frequency or duration of care.
- Reducing the administration burden on physicians for completing nnecessary paperwork for physical therapy service requests that they don't directly provide.
- Requiring disclosure to allow closer monitoring of claimant access barriers or overutilization related to physician self-referral. The C-9 form requires the provider of services to be identified and the requester must also check a box to indicate whether the requestor is the Physician of Record versus a different treating provider.
The new C-9 form may be submitted on-line or a copy may be obtained from the following page link: https://www.ohiobwc.com/provider/forms/c9/secure/C9-0.asp
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