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The Industrial Accidents Division assists medical providers with reporting work related injuries or illnesses and assists medical providers in resolving medical disputes. The Industrial Accidents Division is also responsible in annually updating the medical fee standards.
Reporting A Work Related Injury
If a work-related injury or illness results in lost work time or requires medical treatment, that injury or illness must be reported to the Industrial Accidents Division.
Medical Fee Standards & Impairment Rating Guide
The Utah Labor Commission annually sets the medical fee standards.
Fee Disputes
Payors and healthcare providers shall use the following procedures to resolve billing disputes R612-300-7(I).
Reporting a Work Related Injury
If a work-related injury or illness results in lost work time or requires medical treatment, that injury or illness must be reported to the Industrial Accidents Division. This is done with a “Physician’s Initial Report of Injury or Illness” (Form 123).
A doctor treating an injured employee is required to complete a “Physician’s Initial Report of Injury or Illness” (Form 123) and submit the report to the Industrial Accidents Division within 7 days of the initial visit.
Medical providers may submit the Physician’s Initial Report of Injury or Illness form online. If a medical provider needs access to the Easy Online 123, please register below or contact the Quality & Support team at (801) 530-6809.
Medical Fee Standards & Impairment Rating Guide
The Utah Labor Commission annually sets the medical fee standards and updates, as needed, administrative rules for medical providers as defined and authorized in Utah Code Ann. §34-2-407, Utah Code Annotated.
Fee Disputes
Payors and healthcare providers shall use the following procedures to resolve billing disputes. Utah Administrative Code R612-300-7(I).
- The provider shall submit a bill for services with supporting documentation to the payor within one year of the date of service.
- The payor shall evaluate the bill and pay the appropriate fee as established by these rules.
- If the provider believes the payor has improperly computed the fee, the provider may submit a written request for reevaluation to the payor. The request shall describe the specific areas of disagreement and include all appropriate documentation. Any such request for re-evaluation must be submitted to the payor within one year of the date of the original payment.
- Within 30 days of receipt of the request for re-evaluation, the payor shall either pay the additional fee due the provider or respond with a specific written explanation of the basis for its denial of additional fees. The payor shall maintain proof of transmittal of its response.
- A payor seeking reimbursement from a provider for overpayment of a bill shall, within one year of the overpayment, submit to the provider a written request for repayment that explains the basis for request. Within 90 days of receipt of the request, the provider shall either make appropriate repayment or respond with a specific written denial of the request.
- If the provider and payor continue to disagree regarding the proper fee, either party may request informal review of the matter by the Division. Any party may also file a request for hearing on the dispute with the Adjudication Division.
If the provider or payor has questions about the billing dispute process, please contact the Industrial Accidents Division (801) 530-6800 or iaccd@utah.gov
Application for Hearing
A medical care provider may request a hearing. For more information regarding how to file an Application for Hearing Medical Provider, please contact the Adjudication Division at (801) 530-6800.