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For Workers' Compensation Insurance Companies

The Hand & Wrist Center welcomes workers’ compensation injuries involving the upper extremities*. We realize the importance of finding a balance between excellent patient care and cost-efficiency. In addition, we acknowledge the significant value in timely medical-information reporting, patient-claim processing, and reducing long-term disability factors.

Please be advised that it is our Center’s Financial Policy that all patients have the proper authorization prior to the initial consultation. This authorization should be specified to the type of consultation required, in addition to the requested treatment. Furthermore, this authorization is required in writing and must be received by our office prior to services being rendered. In order to continue the delivery of timely and quality service(s), please assist our Center in obtaining the proper authorization required to ensure payment for our services.

Our services include the following consultations types (*note that each consultation type may or may not require radiologic evaluation, and/or further diagnostic testing):

• Consultation Only: Evaluation by a physician including a complete medical history, diagnosis determination, and outlining a treatment plan.
• Consultation and Treatment: Evaluation by a physician including a complete medical history, diagnosis determination, outlining and initiating a treatment plan; the physician assumes the Primary Treating Physician role.
• Surgical Consultation and Treatment: Evaluation by a physician including a complete medical history, diagnosis determination, outlining and initiating a treatment plan; physician assumes primary responsibility for surgical care, but does not assume the Primary Treating Physician role.
• Second Opinion: Evaluation by the physician for purposes of providing a patient/examinee with an additional medical opinion regarding a specific medical condition – including a complete medical history, diagnosis determination, and outlining a treatment plan in comparison, or contrast, to the opinion of another physician.
• Qualified Medical Examination: Please visit the California Department of Industrial Relations for a detailed description.

Medical-Legal Evaluations

ML-101	Follow-up Medical-Legal Evaluation (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-102	Basic Comprehensive Medical-Legal Evaluation (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-103	Complex Comprehensive Medical-Legal Evaluation (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-104	Comprehensive Medical-Legal Evaluation involving Extraordinary Circumstances (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-105	Medical-Legal Testimony (See Title 8, California Code of Regulations) (Sections 9793, 9795)
ML-106	Supplemental Medical-Legal Evaluation/Report (See Title 8, California Code of Regulations) (Sections 9793, 9795)
AOE-COE	(Arising Out of Employment / in the Course of Employment) (performed upon the request by the employer and/or insurance carrier to address causation factors – i.e. determining if a condition is “work-related”)

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