This section of our Web site contains answers to health care providers' frequently asked questions about Pinnacol Assurance and our provider services. If you would like to add a question, please click here.

Benefits of SelectNet
Billing
History of SelectNet
Pharmacy Benefits Prescription Program
SelectNet Providers
SelectNet Web Site
Treatment Guidelines
Training and Events

Benefits of SelectNet
How does SelectNet benefit Pinnacol Assurance's policyholders?

• Premium discount and claims savings for employers
• Providers are located throughout the state of Colorado
• Strong case management and communication with policyholders

• Injured workers receive prompt, quality medical treatment
• Injured workers return to work sooner
• The number of lost time claims (claims that involve more than three missed work shifts) may be less
  
  

How does SelectNet benefit its providers?
Pinnacol Assurance promotes the designation of SelectNet providers to our policyholders. Currently, SelectNet providers treat 84 percent of our injured workers. Pinnacol serves as aa resource for the SelectNet providers by offering training, provider utilization profile reports, and routine onsite support from a designated provider relations specialist. We help providers streamline processes; offer them online resources such as billing and claims information; and provide them access to industry formsthrough the SelectNet web site. The SelectNet Web site is available exclusively to SelectNet providers.

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Billing
How and when do I bill Pinnacol Assurance?
SelectNet providers must bill Pinnacol Assurance in accordance with the policies and procedures set forth in the Colorado Workers' Compensation Fee Schedule (Rule XVIII).

If you are billing us for the first time, complete a W-9 form and fax it to 303-361-5945. To obtain a W-9, call 303-361-4945. Bills should be submitted to:

Medical Payments Team
Pinnacol Assurance
P.O. Box 469013
Denver, CO 80246-9013

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History of SelectNet
When, how, and why was SelectNet established?
Based on Senate Bill 218, passed in July 1991, workers' compensation insurance carriers are required to offer managed care in specific counties. Pinnacol Assurance stepped up to the plate and enhanced our managed care process, including overhauling our existing managed care network. Our goals were to improve the network, the processes related to the network, and, most importantly, the services the network provides to injured workers and employers.

We obtained feedback from customers and providers and then benchmarked against other provider networks to recreate our network. The result was SelectNet, which officially "launched" in June 1996. The goal of SelectNet is "to provide the right amount of care at the right time, and to safely return injured workers to work as quickly as possible."

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Pharmacy Benefits Prescription Program
How do you handle pharmacy benefits?
Pinnacol Assurance has contracted with Express Scripts to provide pharmacy benefits to our injured workers. Over 90 percent of pharmacies in Colorado participate in this contract. Injured workers receive an Express Scripts information card in the mail explaining how to use program. If an injured worker asks you about the Express Scripts program, please ask them to call their Pinnacol Assurance claims representative.

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SelectNet Providers
How do I become a SelectNet provider?
SelectNet providers must meet certain credentialing criteria. The expansion of the SelectNet network is based on the adequacy of current size and scope to treat Pinnacol Assurance's injured workers. To find out if we are looking for additional providers, please call 303-361-4945.

How can I locate a SelectNet provider?
If you are looking for a SelectNet provider, click here.

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SelectNet Web site
How do I register for the SelectNet Web Site?
The SelectNet Web site, available through Pinnacol Online, provides valuable online tools to Pinnacol Assurance's SelectNet providers with the click of a mouse. To use Pinnacol Online, you need Internet access, a user ID, and a password. Security is ensured by sophisticated user authentication, encryption, and firewall technology. You do not need to install special software to use the system.

If you would like to register with Pinnacol Online, download the "Pinnacol Online Registration Form for SelectNet Providers." Complete the form and fax it to 303-361-5952.

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Treatment Guidelines
What are the medical treatment guidelines and who developed them?
The Division of Workers' Compensation (DOWC) convened task forces to develop medical treatment guidelines, which were adopted by the DOWC. The guidelines include treatment for low back pain, chronic pain disorder, and traumatic brain injury. Click here to view the guidelines. Colorado health care providers who treat injured workers are expected to follow these guidelines.

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Training and Events
What training is available to help me treat injured workers?
The Workers' Compensation Act provides Level I accreditation for licensed chiropractors, dentists, and podiatrists; however, MD/DOs may also apply. Level I accreditation prepares providers to work more effectively in the workers' compensation system by providing special training in legal, administrative and medical issues peculiar to workers' compensation. It also ensures that providers receive reimbursement for treating "lost time" injuries (where the patient is unable to return to work for more than three days), and allows chiropractors to be compensated for treatment provided to injured workers in excess of 12 visits or 90 days (whichever comes first). Level I accreditation is available through Division of Workers' Compensation Level I Accreditation and Reaccreditation seminars, or through the Division's home study course and exam.

Does Pinnacol Assurance sponsor provider events I can attend?
Pinnacol Assurance sponsors an annual SelectNet conference for its providers. For more information, call 303-361-4945.

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