Fla. Admin. Code Ann. R. 69L-30.008 - Billing and Reimbursement for Expert Medical Advisor Services
(1) Within 30 calendar days following
submittal of the written report, the EMA must submit billing, per the contract
with the Department or JCC, for services, documenting total number of hours and
total dollar charges for the contracted services.
(2) If additional diagnostic testing is
required for the EMA to render a medical opinion, charges for diagnostic
testing shall:
(a) Require prior authorization
from the JCC or the Department; and,
(b) Be billed in accordance with rule
69L-7.730, F.A.C.;
and,
(c) Be reimbursed in
accordance with the appropriate Florida Workers' Compensation reimbursement
manual in effect on the date services were completed.
(3) Within 45 calendar days from receipt of
both the written report and invoice, reimbursement shall be rendered to the EMA
pursuant to paragraph
440.13(9)(f),
F.S.
(4) Hourly reimbursement for
EMA services shall be for all services rendered except specialty-diagnostic
testing.
(5) Reimbursement,
pursuant to an EMA Contract, in accordance with subsections
69L-30.005(2) and
(3), F.A.C., shall be as follows:
(a) Except as provided in paragraph (b),
reimbursement shall not exceed $300.00 per hour, per case, not including
reasonable expenses associated with travel, when applicable, which will be
reimbursed in accordance with section
112.061, F.S. The review shall
not exceed 8 hours per case unless specifically approved in writing by the
Department or JCC, as applicable.
(b) When an examination of an injured
employee is required for the EMA to render a medical opinion, charges for an
examination shall:
1. Require prior
authorization from the requesting party;
2. Be billed in accordance with rule
69L-7.730, F.A.C.;
and,
3. Be reimbursed in accordance
with the appropriate Florida Division of Workers' Compensation reimbursement
manual in effect on the date services were rendered.
(c) An EMA shall be reimbursed for travel and
other administrative expenses consistent with the terms of the contract between
the EMA and the Department.
(d)
Fees for EMA deposition testimony are limited to $200 per hour, pursuant to
subsection 440.13(10),
F.S.
Notes
Rulemaking Authority 440.13(9), 440.591 FS. Law Implemented 440.13(9) FS.
New 1-23-95, Formerly 38F-54.008, Amended 10-11-06, Formerly 59A-30.008, Amended 3-1-16.
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