New changes to the Workers' Comp system for vendors and providers

CHARLESTON -– West Virginia Insurance Commissioner Jane L. Cline announced last week that providers and vendors for active workers' compensation claimants who have a date of injury prior to July 1, 2005, should check their mail carefully during the next 30 days for notifications regarding a change in the Third Party Administrator (TPA) handling those claims.

Any claim that has a date of injury prior to July 1, 2005, is classified as an "Old Fund Claim".

Effective Dec. 1, 2007, these "Old Fund Claims" will no longer be handled by Cambridge Integrated Services, but instead will be handled by one of the following TPAs: Sedgwick Claims Management Services, Inc., Wells Fargo Disability Services, Inc. and/or American Mining Claims Service.

Additionally, providers and vendors should be looking for a letter from the new TPA. This introductory letter will contain specific information, including contact, billing and authorization information.

"It is of the goal of the West Virginia Offices of the Insurance Commissioner to improve the administration of the Old Fund workers' compensation claims," Cline said. "It is important providers and vendors pay close attention to all instructions that may be included in these letters to prohibit any potential issue or delays related to authorizations of treatment or payments."

For additional information, please call 877-925-5580.