Select one only: Nurse practitioner's first report (form 8NP) or progress report (form 11NP)
Tick one box. Choose 8NP after the worker's first visit to your office or facility; WorkSafeBC pays the first report it receives from any nurse practitioner at the 8NP rate. Choose 11NP when the worker's condition or treatment has changed since the last report or the worker is ready to return to work, and send one every four weeks or sooner when something changes. Every later report for the same worker is treated as an 11NP.
Worker, employer and claim details
Enter the date of service, the employer's name, phone with area code and operating location address, then the worker's last and first name, middle initial, gender, date of birth, mailing address with postal code, contact phone and personal health number from the BC CareCard. Add the WorkSafeBC claim number and the date of injury, or the date the worker was first treated for the condition. The guide stresses the claim number, especially on an 11NP, because several workers can share a name and birth date and one worker can have two claims for the same body part.
First treatment, regular practitioner, prior problems, time off and concurrent treatments
Record who rendered first treatment and whether you are the worker's regular practitioner (0 to 6 months, 7 to 12 months or more than a year); both can be skipped on an 11NP. Note prior or other problems affecting injury, recovery and disability, and whether the worker has been disabled from work since the injury or last report, with the date. Unlike the physician form, the NP form also asks whether the worker is receiving other concurrent treatments: physiotherapy, massage therapy or other.
Injury codes and descriptions
Give a text diagnosis and three codes: CSA BP/AP for body part and side, CSA NOI for nature of injury, and ICD9. WorkSafeBC's guide says every nurse practitioner report must include diagnostic codes so it can verify the claim. The body part and nature of injury code lists are published on worksafebc.com, and ICD9 codes on the BC government's Medical Services Plan diagnostic code pages.
Clinical information
The form prompts for what happened, subjective symptoms, examination, X-rays used in investigations, the types of treatment (techniques and modalities) and how often they are given, and any specialist consult. Write it as you would a clinic note, covering presenting complaints, findings, treatments and medications, and the name and date of any specialist referral. WorkSafeBC asks for typed reports, since legibility reduces misunderstandings and misinterpretation.
Return-to-work planning
Say whether the worker is medically capable of full duties, full time, and if not, list current physical and/or psychological restrictions. Estimate time before a return to the workplace in any capacity (currently at work, 1 to 6, 7 to 13, 14 to 20 or more than 20 days), whether the worker is ready for a rehabilitation program, and the likely date of maximal medical recovery. A Work Conditioning Program is an active, usually daily program for physical and functional deficits. You can also ask to consult a WorkSafeBC advisor, and the guide suggests contacting the claim owner for return-to-work planning help.
Payee number, payee name, practitioner number and practitioner name
Enter your payee number and practitioner number with the payee and practitioner names. WorkSafeBC stresses that nurse practitioners must supply both numbers to be reimbursed, and asks new providers to get a payee number from its Procurement Services team and use it in all communications. The fee itself is invoiced separately, through My Provider Services or Generic Invoice Form 83D128.