Tenn. Comp. R. & Regs. 0800-02-20-.07 - PAYMENTS/FEES REGISTRY

(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: $1250.00.
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: $1500.00.
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." At the Program Coordinator's discretion, the evaluation fee may be increased up to an additional $ 500.00 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. 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. More involved lung function testing including additional spirometry because the results in the medical record do not demonstrate that acceptability and repeatability criteria have been satisfied, measurement of DLCO and Vo2 Max, and pre- and post-bronchodilator spirometry or methacholine challenge tests in cases of asthma, if not reasonably current and available in the medical record should be discussed with the Program Coordinator, and if approved can then be ordered by the MIR physician at a testing facility reasonably near the worker's residence, with the employer/insurer financially responsible for the testing. Any additional x-rays that the registry 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 an evaluation appointment shall be given to the Program Coordinator at least three (3) 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. The Program Coordinator shall decide whether an evaluation may be rescheduled within ten (10) calendar days of a request to cancel. If the request is not timely, the MIR Registry physician shall be entitled to collect/retain a $300.00 cancellation fee. If the evaluation is rescheduled, the MIR Registry physician is entitled to the entire evaluation fee (for the scheduled evaluation) in addition to this fee.
(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 the cancellation fee.
(b) If the employee untimely cancels an appointment with the MIR registry physician without good cause or fails to appear without good cause, as determined by the Program Coordinator, the employer shall pay the 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.
(c) 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 Rule 0800-02-20-.11; provided, however, the MIR Physician shall not conduct a physical evaluation.

Notes

Tenn. Comp. R. & Regs. 0800-02-20-.07
Public necessity rule filed June 15, 2005; effective through November 27, 2005. Public necessity rule filed November 16, 2005; effective through April 30, 2006. Original rule filed January 30, 2006; effective April 15, 2006. Amendments filed March 25, 2013; effective June 23, 2013. Amendment filed December 26, 2013; effective March 26, 2014. Amendments filed June 10, 2016; effective 9/8/2016.

Authority: T.C.A. §§ 4-5-202, 50-6-102, 50-6-204, 50-6-205, 50-6-233, and Public Chapters 282 & 289 (2013).

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