Minnesota Rule 5221.6050 requires prior notification to the workers’ compensation insurer by the medical provider in some situations. In general, medical providers should request authorization from the workers’ compensation insurer at least seven (7) days before proposed medical treatment. That request can be made in writing or orally.
Regardless of the format, the medical provider should keep track of the request. The workers’ compensation insurer then has seven (7) days in which to respond (in writing or orally).
If the workers’ compensation insurer does not respond within seven (7) days, then the medical provider can assume that the proposed treatment is authorized and go ahead with the care.
If the workers’ compensation insurer requests additional information, requests a second opinion or an adverse medical examination, or simply denies the care, the medical provider should notify the injured worker and/or his/her attorney as soon as possible.
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