 |
Washington Administrative Code (Last Updated: November 23, 2016) |
 |
Title 296. Labor and Industries, Department of |
|
Chapter 296-20. Medical aid rules. |
Section 296-20-02702. Who uses medical coverage decisions?
Latest version.
- Self-insured employers and state fund claim managers use medical coverage decisions to help them make claim-specific decisions. For example, the director or director's designee may find that a particular medical device is effective in treating a specific category of injuries. The medical coverage decision might be that that device is a covered benefit for that category of injuries. The self-insured employer or state fund claim manager would make a claim-specific decision to pay or deny payment for that device based on a number of factors, one of which is whether the accepted condition on that claim matches the approved category of injuries in the medical coverage decision.