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This is an obsolete version of the rule. Please click on the rule number to view the current version.

24.29.1404    DISPUTED MEDICAL CLAIMS

(1) Disputes arising over the following issues are resolved by a hearing before the department upon written application of a party to the dispute or the injured worker:

(a) amounts payable to medical providers, when benefits available directly to claimants are not an issue;

(b) access to medical records;

(c) timeliness of payments to medical providers; or

(d) requirements for documentation submitted by a provider to an insurer pursuant to ARM 24.29.1513 as a condition of the payment of medical fees.

(2) All other disputes arising over medical claims, including travel expense reimbursement to injured workers, shall be brought before a department mediator as provided in part 24 of the Workers' Compensation Act.

(3) Hospital records shall be furnished to the insurer upon request. Hospitals shall obtain, upon admission, the necessary release by their administrative procedures.

(4) The rule of privileged communication is waived by the injured worker seeking benefits under the Workers' Compensation or Occupational Disease acts.

History: 39-71-203, MCA; IMP, 39-71-203, 39-71-704, MCA; Eff. 12/31/72; AMD, 1991 MAR p. 2622, Eff. 12/27/91; AMD, 2007 MAR p. 260, Eff. 2/23/07.

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