Date: December 13, 2012
A new web tool is available for medical providers and injured workers to determine whether they must use a Diagnostic Testing Network (DTN).
In April, I announced the adoption of DTN regulations governing the mandatory use of network radiologists (or other specialists) for MRIs and other diagnostic tests. I also invited stakeholders to complete a survey about the benefits of developing an online tool to enable injured workers and medical providers to look up whether a particular self-insured employer, insurance carrier, or Third-Party Administrator (TPA) requires use of a DTN.
Stakeholders uniformly agreed that a look-up tool on the Board's website would provide valuable information for injured workers and medical providers. Board representatives conducted extensive outreach to understand the network relationships and what information would be most useful to medical providers and injured workers. Board IT staff then developed the look-up function, which is now available to anyone through the Board's website.
Claim administrators (self-insured employers, insurance carriers and TPAs) that require injured workers to use their DTNs must provide the Board with information about their mandatory DTNs. The information supplied by claim administrators will be posted on the Board's website and used with the look-up tool. To comply with this requirement, administrators must register for access to a self-service application where they can select their DTN from a list of DTNs registered with the Board. Claim administrators must report any changes to their list of DTNs, such as new or removed DTN contracts, to the Board via the self-service application within 20 days of the effective date of the change. The DTNs must also provide current contact information (email, telephone, and website) to the Board to ensure the accuracy of the DTN look-up application and compliance with the DTN regulations. DTNs must report any changes to their contact information within 20 days of the effective date of the change. Failure of a claim administrator or DTN to timely supply accurate information and keep this information up-to-date may interfere with the claim administrator's ability to require an injured worker to use a Diagnostic Testing Network. It is also important to note that the look-up tool does not replace the claim administrator's responsibility to notify the injured worker and treating medical provider of the existence of a DTN, as required by the regulations.
Injured workers, medical providers and staff may search by claim administrator to determine if it has contracted with a DTN. Some claim administrators may list more than one DTN. Generally, the injured worker can go to any of the listed DTNs associated with the claim administrator unless it includes special instructions in the look-up tool about which DTN to use. If the claim administrator does not appear in the look-up tool, it has not registered its mandatory use of a DTN with the Board. In that case, injured workers may obtain diagnostic tests from a provider of their choice.
Any questions may be directed to the Board's Bureau of Health Management at DTNfiling@wcb.ny.gov or 1-(800) 781-2362.
Robert E. Beloten