TDI/TCI For Qualified Healthcare Providers (QHP) A QHP, licensed in the USA, encompasses various healthcare professionals who can certify individuals’ inability to work due to non-work-related illness or injury, including those in medicine, surgery, dentistry, optometry, osteopathy, podiatry, chiropractic, psychology, and related fields like clinical social work, certified nurse-midwife, Nurse Practitioners, and psychiatric care. What Qualified Healthcare Providers Need to Know PDF file, less than 1mbmegabytes Now Recruiting New Providers to Become Impartial Medical Examiners for TDI! What is an Impartial Medical Examiner for TDI? The Rhode Island Department of Labor and Training is seeking Qualified Healthcare Providers to conduct impartial medical examinations and occupational evaluations of individuals receiving Temporary Disability Insurance (TDI) benefits. The purpose of the exams is to determine fitness for duty. Interested Qualified Healthcare Providers must possess knowledge and expertise in occupational health fitness. Additional requirements include possession of a full and unrestricted license to practice medicine in the State of Rhode Island. Impartial medical examiners must be willing to examine patients, determine fitness for duty and submit reports in a timely manner. Billing for impartial medical examinations will be in accordance with the TDI fee schedule as established by the department. Current impartial medical examiners are required to reapply. Impartial medical examiners are needed in all locations throughout the state and in all medical specialties, but are especially needed in the fields of psychiatry, internal medicine, general surgery, podiatry, orthopedic and rheumatology. Application and Forms Application For Medical Examiner PDF file, less than 1mbmegabytes Impartial Medical Examiner's Agreement PDF file, less than 1mbmegabytes W-9 PDF file, less than 1mbmegabytes Mail completed forms to: Temporary Disability Insurance PO Box 20100 Cranston, RI 02920 Updated 2024 Fee Schedule Impartial Medical Examiners will be paid according to the following fee schedule: Doctor of Medicine (MDs) - $500 Non-MDs - $300 (ex. Chiropractors, Advanced Practice Registered Nurse (APRN), Physician Assistant (PA), Social Worker, Nurse-Midwife, etc.) Rules of the Road from the RI Dept. of Health Board of Medical Licensure and Discipline The Board of Medical Licensure and Discipline worked with state auditors to investigate potential misuse of the TDI evaluation system. A pattern emerged, revealing how some patients have annually received certifications for TDI at times that coincide with traditional seasonal layoffs for certain occupations. Rules of the Road from the Board of Medical Licensure and Discipline PDF file, less than 1mbmegabytes Healthcare Providers FAQ What are the medical eligibility requirements for TDI? To be medically eligible for TDI benefits, a Qualified Healthcare Provider (QHP) must certify the patient functionally unable to perform their customary and regular work duties and provide the length of time the patient is expected to be unable to work. For eligibility to begin the first day he/she is disabled the patient must have an in-office examination by a licensed QHP that week, the week before or the week after, the disability began. A contact with the QHP via a telephone call is not acceptable by TDI law as a timely examination by a licensed QHP. Additionally, the patient may be asked to make an appointment with an impartial medical examiner if we believe an exam is necessary. Benefits will be stopped if the claimant does not make or keep the appointment with the impartial medical examiner. My patient is receiving TDI; can I bill TDI for medical expenses? TDI provides income support to individuals who are out of work because of a non-work related illness or injury. TDI does not pay for medical expenses for the illness or injury. Can I obtain information on my patient's TDI claim? NO, all information regarding a TDI claim is confidential. What happens when a disability duration exceeds medical guidelines? When a disability duration exceeds the medical duration guidelines (MDG) the claim is referred to the Claims Management Unit for further review. A Registered Nurse in the Unit will make an additional review of the claim and if necessary, will contact the Qualified Healthcare Provider and/or the TDI customer for additional information. Does TDI have any procedures for preventing fraud and the misuse of benefits? TDI is very proactive with respect to fraud and the misuse of benefits. By law, TDI can require individuals to be examined by an impartial qualified healthcare provider in order to determine continued disability and eligibility for benefits. The Medical Review Unit refers claims to the TDI Medical Consultant for further review and recommendation as needed. Medical duration guidelines (MDG) are used by the Medical Review Unit to determine disability durations. TDI has an internal program to determine if someone has received TDI benefits during a period when he or she was working. TDI is in constant contact with the Workers' Compensation Court and insurance carriers and with the Unemployment Insurance Division to determine if someone is receiving TDI benefits that he or she is not entitled to. What is an impartial qualified healthcare provider for TDI and how can I become one? TDI has a database of impartial qualified healthcare providers for all medical specialties, serving the entire state. TDI is constantly seeking to increase the number of impartial qualified healthcare providers in order to better service its customers. If you are interested in becoming an impartial examiner you may contact TDI at 401-462-8381 or e-mail TDI at dlt.tdi@dlt.ri.gov If you prefer, you may write to TDI at: Temporary Disability Insurance, P.O. Box 20100, Cranston, Rhode Island 02920-0941. I have a patient who is requesting time out of work to take care of a sick relative and also wishes to apply for TDI; can I certify a person for TDI who is out of work on family medical leave? NO. TDI only pays benefits to workers who are ill or injured and does not extend benefits to persons taking care of a sick relative while on family medical leave. Advise your patient to apply for Temporary Caregiver Insurance (TCI). Healthcare Providers 401-462-8447 DLT.TDI@dlt.ri.gov
Rules of the Road from the Board of Medical Licensure and Discipline PDF file, less than 1mbmegabytes