Receiving payment
Part of our role in the workers’ comp system is making sure you receive payments you are due for providing medical treatment to an injured worker.
On average, SAIF makes claims decisions in about half the time allowed by law, which allows us to pay medical providers more quickly.
Determining payment
Payment for medical treatment of an injured worker is made according to the Oregon fee schedule, the usual and customary rate, or another negotiated rate - whichever is less.
Two factors comprise the fee schedule: the conversion table set by the Workers' Compensation Division and determined by state law, and the Relative Value Unit, which is set by the federal government.
Determining payment
Payment for medical treatment of an injured worker is made according to the Oregon fee schedule, the usual and customary rate, or another negotiated rate - whichever is less. Two factors comprise the fee schedule: the conversion table set by the Workers' Compensation Division and determined by state law, and the Relative Value Unit, which is set by the federal government.
Billing the worker
If we do not pay an entire bill, you cannot bill the injured worker for any medical service or treatment related to the compensable injury. Exceptions include:- Treatment that has not been prescribed by the attending physician or specialist physician upon referral by the attending physician
- Palliative care that is not compensable and/or not pre-authorized by the insurer
- Treatment outside the provisions of the governing MCO contract
- Treatment after being notified that such treatment is considered unscientific, unproven, outmoded or experimental