Tenn. Comp. R. & Regs. 0800-02-20-.07 - PAYMENTS/FEES
(1) The following timeframes shall exclude
legal holidays. A physician performing evaluations under these Rules shall be
prepaid by the employer a total evaluation fee for each evaluation performed,
under a MIR Registry physician estimated timetable as outlined below
(a) Completed reports that do not require a
psychiatric evaluation:
1. Completed reports
received and accepted by the Program Coordinator within thirty (30) calendar
days of completing the examination: $1,500.00.
2. Completed reports received and accepted by
the Program Coordinator between thirty-one (31) and forty-five (45) calendar
days of the completing the examination: $1,250.00.
3. Completed reports received and accepted by
the Program Coordinator between forty-six (46) and sixty (60) calendar days of
the completing the examination: $750.00.
4. Completed reports received and accepted by
the Program Coordinator later than sixty (60) calendar days of completing the
examination: No fee paid.
(b) Completed reports that do require a
psychiatric evaluation:
1. Completed reports
requiring a psychiatric evaluation and received and accepted by the Program
Coordinator within thirty (30) calendar days of completing the examination:
$2,000.00.
2. Completed reports
requiring a psychiatric evaluation and received and accepted by the Program
Coordinator between thirty-one (31) and forty-five (45) calendar days of the
completing the examination: $1,500.00.
3. Completed reports requiring a psychiatric
evaluation received and accepted by the Program Coordinator between forty-six
(46) and sixty (60) calendar days of the completing the examination:
$1,000.00.
4. Completed reports
requiring a psychiatric evaluation received and accepted by the Program
Coordinator later than sixty (60) calendar days of completing the examination:
No fee paid.
(2) The evaluation fee includes normal record
review, the evaluation, and production of a standard "MIR Report."
(a) At the Program Coordinator's discretion,
the evaluation fee may be increased up to an additional $750.00 if the MIR
Report appropriates diagnoses from two or more chapters of the AMA
GuidesTM or if the time required for the record
review, evaluation, or production of the MIR Report is extraordinary, or if the
production of the report requires consultation with other providers.
(b) All non-routine test(s) for an impairment
rating essential under the applicable edition of the AMA
GuidesTM to the Evaluation of Permanent Impairment
shall have been performed prior to the evaluation. Routine tests necessary for
a complete evaluation, such as range of motion tests, should be performed by
the MIR Registry physician as part of the evaluation at no additional
cost.
(c) Visual acuity and field
vision tests, lung and heart function tests, and any other non-routine tests,
if not reasonably current, valid, and available as determined by the Program
Coordinator in consultation with the MIR Physician, may be ordered at a testing
facility reasonably near the worker's residence, with the employer/insurer
financially responsible for the testing.
(d) Any additional x-rays that the MIR
Physician deems necessary to render the MIR Report must be approved in writing
by the Program Coordinator and are subject to the Medical Fee
Schedule.
(3)
Cancellations. To be considered timely, notice of a party's desire to cancel or
reschedule an evaluation appointment shall be given to the Program Coordinator
at least seven (7) business days prior to the date of the evaluation. An
evaluation may be canceled or rescheduled only after obtaining the consent of
the Program Coordinator.
(a) If the request is
made three (3) business days from the date of the evaluation or less, the MIR
Physician shall be entitled to collect/retain a $500.00 untimely cancellation
fee. If the evaluation is rescheduled, the MIR Registry physician is entitled
to the untimely cancellation fee in addition to the entire MIR fee.
(b) If, after the MIR Physician is in receipt
of the medical records, the cancellation request is made less than seven (7)
business days from the date of the evaluation, but more than three (3), and the
evaluation is not rescheduled, then the MIR Physician shall be entitled to
collect/retain a $300 cancellation fee.
(4) Payment of Cancelation Fees:
(a) If the employee cancels untimely with
good cause or fails to appear for the evaluation with good cause, as determined
by the Program Coordinator, the Program Coordinator may reschedule the
evaluation, and the employer shall pay any cancellation fee.
(b) If the employee untimely cancels an
appointment with the MIR Physician without good cause or fails to appear
without good cause, as determined by the Program Coordinator, the employer
shall pay any cancellation fee(s) and may seek to recover said fee(s) upon
proper application to the Court of Workers' Compensation Claims at any
subsequent hearing, upon written motion, before the Court, including a
settlement approval.
(5)
If the employee untimely cancels without good cause or fails to appear without
good cause more than once, the Program Coordinator may authorize the MIR
Physician to produce an MIR Report in compliance with these Rules; provided,
however, the MIR Physician shall not conduct a physical evaluation.
Notes
Authority: T.C.A. ยงยง 50-6-102, 50-6-204, 50-6-205, and 50-6-233.
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