Medical fees are paid based on what?

Prepare for the Rhode Island Workers Compensation Adjusters Test. Utilize flashcards and multiple-choice questions, each equipped with hints and explanations. Successfully ready yourself for your exam!

Multiple Choice

Medical fees are paid based on what?

Medical fees in Rhode Island workers’ compensation are determined by two schedules, chosen by where the service is performed. Hospital services—such as inpatient stays, emergency department visits, and ambulatory surgery—are paid under the Hospital Fee Schedule. All other medical services, including physician professional fees, outpatient testing billed as professional services, therapy, and similar care, are paid under the Medical Fee Schedule. A flat rate set by the insurer is not used. So the correct approach is to apply the Hospital Fee Schedule for inpatient, ER, or ambulatory surgery and the Medical Fee Schedule for all other services.

Medical fees in Rhode Island workers’ compensation are determined by two schedules, chosen by where the service is performed. Hospital services—such as inpatient stays, emergency department visits, and ambulatory surgery—are paid under the Hospital Fee Schedule. All other medical services, including physician professional fees, outpatient testing billed as professional services, therapy, and similar care, are paid under the Medical Fee Schedule. A flat rate set by the insurer is not used. So the correct approach is to apply the Hospital Fee Schedule for inpatient, ER, or ambulatory surgery and the Medical Fee Schedule for all other services.

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