1. Guidelines and Reimbursement

3.  Minimize use of opiates  Prompt return to work is encouraged  Convey work restrictions to the patient’s employer  Refer to Occ. Medicine clinic for follow up  Prompt follow up encouraged, especially if time off

4.  Patient fills out Report of Accident (ROA) and signs  Provider complete as much as possible  Sign and date form  Complete Activity Prescription Form (APF) form  Registration faxes form Not completing/faxing form rejects and/or delays care which correlates in poorer outcomes and increased disability!

5. Report of Industrial Injury or Occupational Disease If you think the work injury is related to work on a more probable than not basis (more than 50% probability, you should mark “probably” or “yes” (blue section, box 7). If you think the injury is not related to work mark “no” or “possibly”.

7. Filled out and submitted with initial ROA This info is in the middle of the APF form. Document whom you called, what was discussed (work restrictions and duration of restrictions) and the time it took

9.  APF Form$50.82  Telephone call with employer $23.43 – 66.78  Report of Accident (L&I form)  Within 2 business days$58.65  Within 3 - 5 days$39.10  Within 6 – 8 days$29.10  More than 9 days$19.10 Rates from July 2014 COHE Fee Schedule on www.lni.wa.govwww.lni.wa.gov

10. 1. View the Enrollment webinar. http://www.chifranciscan.org/Health-Care-Services/COHE/Resources/ 2. Complete the Enrollment quiz. http://www.chifranciscan.org/Health-Care-Services/COHE/Resources/ 3. Complete the COHE provider application (see attached) email completed form to the COHE Alliance of Western WA and cc Laurel Green…  wwcohe@chifranciscan.org wwcohe@chifranciscan.org  Laurel_Green@teamhealth.com Laurel_Green@teamhealth.com

11.  Activity helps you recover  Some discomfort is normal when returning to activities after an injury  You can help with your own recovery  You can protect yourself from re-injury  Early and safe return to work makes sense

12.  L&I paperwork is vital to ensure quality patient care  Registration key in facilitating and forwarding claims  APF form does exist and should be clipped to all forms for completion  3 opportunities for reimbursement, up to $175+ per claim  Document in EPIC that you completed ROA, APF and +/- call to supervisor