The State of Georgia has two medical provider systems by which an injured worker may seek treatment for a work-injury: Managed Care Organizations (MCOs) or a Traditional Panel. The majority of workers in this State will be treating under a Traditional Panel. If your patient is treating under an MCO, WC-205 may not be the most appropriate process for obtaining Advance Authorization for treatment.
If your patient is treating with you based on a Traditional Panel, and you are an Authorized Treating Provider, please be aware that the State of Georgia does not require pre-authorization for treatment. See, State Board of Workers’ Compensation Rule 205(b)(2) (“Advance authorization for the medical treatment or testing of an injured employee is not required…as a condition for payment of services rendered.”)
However, the State Board of Workers’ Compensation recognizes that doctors and other medical providers may be hesitant to provide treatment without authorization from the Insurance carrier. To help expedite authorization, the State Board created Form WC-205. This form can be used to request diagnostic studies, such as an MRI, to request treatment, such as epidural injections, or for referrals to other doctors. This form can also be used for studies or treatment which can rule in or rule out a diagnosis as provided in the Board Rule 205 (b)(1).
You may obtain a copy of the most recent Form WC-205, and other forms, at the State Board’s web site here.