Prospective Review of Medical Care (Not Requiring Preauthorization)

As of October 1, 2004, a new process (PRM) became effective with regard to medical care. This process addresses the medical necessity of medical care that does not require preauthorization, prior to that care being provided. This voluntary process is available to doctors providing medical care to injured workers which:

• does not require preauthorization,
  
• has not yet been provided,
  
• is to treat a current medical condition that is related to the compensable injury, and
  
• for which the carrier has indicated an intent to deny reimbursement.

Below you will find some information to help you understand this new process.

• PRM Overview (PowerPoint)
• PRM Frequently Asked Questions (PDF)
• PRM Fast Facts (PDF)
• Example Form DWC-49 (PDF)
• Blank Form DWC-49 (PDF)
• Roles/Responsibilities in the PRM Process (PDF)
• PRM Rule (134.650)  
• DWC Field Offices Listed By County
  

Statistical information for the Prospective Review of Medical Care process (May 2005)

• Procedure & Diagnosis Codes (Excel)
• PRME Statistics (Excel)