North Carolina Administrative Code
Title 11 - INSURANCE
Chapter 23 - INDUSTRIAL COMMISSION
Subchapter D - WORKERS' COMPENSATION RULES FOR MANAGED CARE ORGANIZATIONS
Section .0100 - RULES
Section 23D .0107 - INFORMATION FOR EMPLOYEE

Universal Citation: 11 NC Admin Code 23D .0107

Current through Register Vol. 39, No. 6, September 16, 2024

(a) Following the onset of an injury, the employer or MCO shall provide to the employee a printed explanation of the system being utilized for his care, suitable for sharing with emergency, "out-of-network", and referral physicians, that shall be filed with any Form 19 submitted to the Commission; provided, that electronic filers may otherwise notify the Commission of the identity of the MCO. This statement shall include the following information:

(1) the offices to contact concerning medical treatment for the injury, including a telephone number;

(2) if known at that time, the employee's chosen treating physician, including a phone number for seeking medical assistance outside normal business hours if the injury might cause such a need;

(3) the applicable methods for choosing and changing treating physicians and resolving disputes concerning physicians or treatment pursuant to G.S. 97-25.2;

(4) that the MCO can provide access to licensed physicians of all specialties;

(5) the employer's obligation to pay for treatment for which the employee is referred to the MCO, whether or not the employer admits liability for the injury per G.S. 97-90(e);

(6) the employee's duty to cooperate in treatment, and right to secure treatment at his or her own expense that does not interfere with the treating physician's treatment; and

(7) the Commission's File Number, if known when filed.

(b) Providers may include identifying billing information on the statement.

Authority G.S. 97-25.2;
Eff. January 1, 1996;
Amended Eff. July 1, 2014;
Recodified from 04 NCAC 10D .0107 Eff. June 1, 2018.

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