To establish criteria for determining who is eligible to receive occupational medicine services at University Health Services (UHS).
Scope:
Staff, Students, and faculty who can receive occupational medicine services.
Policy:
The following groups are generally eligible to receive occupational medicine services offered by UHS:
UW–Madison staff, faculty, and students who require pre-exposure and surveillance services due to health risks from their UW–Madison work and/or academic activities;
UW–Madison staff, faculty or student employees who require medical treatment following a UW–Madison workplace exposure and/or injury. Services are limited to employees within the research enterprise and limited to those conditions within the scope of care of the UHS Occupational Medicine program. Costs associated with such services for employees will be billed to Worker’s Compensation;
UW–Madison staff, faculty, and students who request medical consultation due to workplace or academic health concerns. Initial consultation without diagnostic testing is not associated with fees to either the department or to the individual;
Currently enrolled students of the University of Wisconsin–Madison who have paid the campus segregated health fee for the academic term during which services are sought who require treatment of any workplace exposure and/or injury upon referral from a UHS Primary Care provider. Initial evaluation and treatment will be provided by a UHS Primary Care provider. Costs associated with services provided at UHS are covered as part of student segregated fees. Costs for any non-UHS service are the responsibility of the student and/or their health insurance; and
Students who were enrolled in the immediately preceding spring semester but are not enrolled in the summer who have elected to pay the summer health fee who require treatment of any workplace exposure and/or injury upon referral from a UHS Primary Care provider. Initial evaluation and treatment will be provided by a UHS Primary Care provider. Costs associated with such services are covered as part of student segregated fees.
The following groups are eligible to receive specified limited services at UHS:
Non-students whose eligibility to receive specified services is authorized by any other contract or agreement that has been executed and approved in accordance with state, university, and campus rules and procedures and who either pay fees at the time of service or whose fees are paid on their behalf by an agency of government in accordance with the agreement;
UW–Madison faculty, staff, or students or affiliated individual not otherwise eligible upon referral of the UW–Madison Occupational Health Officer upon consultation and approval of the UHS Executive Director; and
Established patients or clients whose eligibility for services ordinarily would have ended under this policy but whose continued eligibility for services is determined in writing by either the Director of Medical Services or the Executive Director to be in the best interests of the patient and UHS and who pay for services received on a fee-for-service basis.
Procedure:
This policy shall be placed on the website of UHS as the Director of Administrative Services shall determine and shall be the means by which all UHS clinicians and staff respond to questions of eligibility individuals seeking occupational medicine services at UHS.
UHS will verify eligibility for occupational medicine services at the time of first contact with the patient.
Faculty staff members and student employees requesting pre-exposure and surveillance occupational medicine services should provide a completed occupational medicine requisition.
UW–Madison students requesting pre-exposure and surveillance services will be informed of costs associated with such services prior to receiving services.
Faculty, staff members, and student employees should complete a Worker’s Compensation report of 1st injury as soon as possible following a workplace exposure and accident.
The Administrative Services unit shall be responsible for reflecting the current eligibility status of students, faculty, and staff in the clinical information system of UHS. The primary source of such supporting data shall be the enrollment records of the University of Wisconsin–Madison created and maintained by the Registrar of the Madison campus in the UW–Madison universal directory system (UDS) and employment records maintained by the Office of Human Resources.
UHS staff members who have questions concerning eligibility of any individual seeking services may direct those questions to the following in the order shown:
The Occupational Health nurses;
The Nurse Manager of the Occupational Medicine Program;
The Director of Environmental and Occupational Health;
The Director of Medical Services; and
The Executive Director
Any person who believes that he or she has improperly been denied services at UHS may address a letter to the Director of Administrative Services. In the event of further dispute, the matter may be appealed to the Executive Leadership Council but the decision of the Executive Director shall be final.
