The RVPG Manual sets forth the proposed operational guidelines and requirements applicable to the provider panel of RVPG. It addresses specialized features applicable to provider under the RVPG contract.
The Provider Manual is incorporated into the RVPG Joinder Agreement and is binding on the provider panel. Among other matters, it sets forth the list of services requiring preauthorization, timelines for reconsiderations, applicable treatment guidelines, medical bill submission requirements, continuity of treatment guidelines, and the provider grievance process.
All participating providers will receive a copy of the RVPG Provider Manual. If you are a member of the RVPG provider panel and cannot locate the manual, contact us at [email protected] to obtain another copy.
River View Provider Group requires pre-authorization for certain medical services. As such, River View Provider Group has developed a comprehensive list of services that require pre-authorization prior to obtaining medical treatment. You can review this list via the following link.
List of Services requiring Preauthorization
In order to pre-authorize a service, please contact a Careworks representative at:
Fax: 877-922-7236
Phone (for inquiries only): 866-286-0281
The preauthorization request form can be accessed via the following link:
Preauthorization Request Form
River View Provider Group medical providers are expected to work with Sedgwick case managers in an effort to get the right care to the injured worker at the right time for the optimal outcome. Case managers will work closely with the treating physician and other providers, the injured worker’s supervisor, the workers’ compensation claims adjuster, and the injured worker to assure a successful return to work or alternate duty program where medically prudent.
If you would like to nominate a healthcare provider to be considered for inclusion on the exclusive River View Provider Group panel, please submit the following nomination form:
Provider Nomination Form
Please be advised that River View Provider Group maintains an exclusive panel of providers and may not have need for additional providers at this time.
While we maintain a limited provider panel, from time-to-time our member employers need additional providers in their geographic region. See the Provider Nomination section to the right hand side of this page for more info.
You can submit medical bills to the following:
Sedgwick/CareWorks
P.O 14520
Lexington, KY 40512
Phone: 866-495-7844
Fax: 859-825-6893
Direct all billing inquiries to the following:
CareWorks
Phone: 800-635-9810
Fax: 713-621-9511
Email: [email protected]
Address: 1080 Eldridge Parkway, 12th Floor
Houston, TX 77077
Yes, unless you get permission from the workers’ compensation adjuster at Sedgwick to refer to a non-participating provider. This can happen if the injured worker needs specialty care that is not contracted with River View Provider Group or if other special needs exist. You can access the River View Provider Group provider panel using the Provider Directory on this website. If you need to submit a request for consideration of a non-participating provider, please contact the workers’ compensation adjuster at 800-580-5477.
You can review this list by selecting this link:
