Referring Tacoma Patients for Specialized Workers' Compensation Treatment

When a Tacoma patient has exhausted standard care options and needs a more structured interdisciplinary approach, Convivio Health can help evaluate program fit, prepare for scheduling, and coordinate the steps needed to get treatment authorized and underway at our Renton or Lynnwood locations.

Submit a Referral

Request Program Fit Review

Before scheduling or making travel plans, confirm with your claim manager or insurer what is approved, what documentation is needed, and what travel-related support may be available for your claim.

When an Outside-Community Referral

Is the Right Call

Some workers' compensation cases in Tacoma involve injuries that do not resolve on a standard timeline. Patients presenting with persistent complex pain or cognitive and functional challenges following a workplace injury may have reached the limits of what standard conservative care can address. When that happens, a structured interdisciplinary program becomes the clinically appropriate next step.

When a patient's case calls for one of these programs (SIMP and BIRP), Washington's MARFS framework supports an outside-community referral, provided the referring documentation includes the medical basis for the referral and an explanation of why care outside the local community is reasonable and clinically necessary. Convivio Health's intake team can support that process with program information, scheduling details, and referral coordination.

Programs Available for Tacoma Referrals

SIMP

Structured Interdisciplinary Pain Management

For patients with chronic, complex, or functionally limiting work-related pain who have not progressed meaningfully through standard conservative treatment.

Renton & Lynnwood

BIRP

Brain Injury Rehabilitation Program

For patients with cognitive, behavioral, or functional deficits following a workplace brain injury, including difficulties with attention, memory, work readiness, and daily function.

Lynnwood only

Setting Up the Initial Evaluation

The entry point for all Tacoma referrals is Convivio Health's intake team. Here's

what happens after first contact.

Intake Contact

The referring provider, claim manager, or vocational counselor contacts Convivio Health's intake team with patient and claim information.

Program Fit Review

The intake team reviews clinical documentation, treatment history, claim details, and functional presentation to assess whether SIMP or BIRP is appropriate.

Location and Scheduling

Confirmed For SIMP referrals, either Renton or Lynnwood may be appropriate depending on scheduling. BIRP referrals are directed to Lynnwood. Available scheduling windows are communicated to the referring party and claim manager.

Evaluation Pre-authorized

Pre-authorized Pre-authorization is obtained for the initial evaluation. Travel to the appointment is coordinated with the claim manager for Tacoma patients traveling to Renton or Lynnwood.

Initial Evaluation Completed

The patient comes in for their initial evaluation. Our clinical team assesses their current condition, functional goals, and program readiness. Evaluation results are submitted to the insurer to obtain authorization for treatment.

Treatment Scheduled

Once treatment is authorized, the program is scheduled. SIMP runs approximately 4 weeks, BIRP approximately 8 weeks. Travel for the treatment period is coordinated with the patient and claim manager.

To request a preliminary fit review before a full referral packet is ready, contact intake directly with a brief clinical summary. The team can advise on whether the patient's presentation is consistent with SIMP or BIRP criteria before formal referral documentation is assembled.

Coordinating Travel Authorization With

the Claim Manager

Convivio Health does not determine what travel costs are reimbursable. Here's how we support the process on each side.

What Convivio Provides

Program descriptions and clinical rationale documentation
Confirmed location address and contact information
Scheduling details once intake is complete
Appointment verification per our standard process

What to Include in Chart Notes

Clinical indication for SIMP or BIRP
Statement that this program is not locally available in the Tacoma area
Medical rationale for why the Renton or Lynnwood location is appropriate for this patient

Referral Documentation Checklist

Send the following with your referral to support a thorough and timely intake review.

Patient name, date of birth, and contact information

Claim number and date of injury

Accepted conditions or diagnosis

Claim manager name, phone, and email

Referring provider contact information

Chart notes from the past 60 to 90 days

Relevant imaging or diagnostic reports

Current functional status and work restrictions

Authorization details if already obtained

Program preference (SIMP, BIRP, or unsure)

Incomplete referrals slow the intake process. The more clinical context provided upfront, the faster fit can be assessed and scheduling initiated.

How the SIMP Program Helps People Move Forward

Fit inquiry or referral submitted to Convivio intake.

Clinical review completed. SIMP or BIRP fit assessed.

Evaluation pre-authorized. Travel to Lynnwood or Renton arranged for patient.

Initial evaluation completed at Convivio Lynnwood or Renton location.

Evaluation results submitted to insurer. Treatment authorization obtained.

Travel is confirmed and treatment is scheduled.

Program begins at confirmed Convivio location.

Provider and Claim Manager FAQ

Who can make a referral for a Tacoma patient?

Referrals may come from the treating physician, claim manager, vocational counselor, employer, or other authorized participants in the workers' compensation case.

Is prior authorization required before scheduling?

Requirements vary by insurer, program, and claim. The claim manager should confirm authorization requirements before scheduling is finalized.

Can Convivio Health help with the claim manager's travel authorization decision?

Yes. We provide program information, location details, and scheduling confirmation to support the review. Travel reimbursement decisions rest with the insurer or claim manager.

What if the patient's claim is under dispute?

Contact the intake team to discuss. Eligibility and scheduling considerations may vary depending on claim status.

Can Convivio provide appointment verification?

Confirm current verification procedures directly with the intake team.

Start the Referral Process for a Tacoma Patient

Our intake team handles referrals from Tacoma providers and claim managers regularly. Whether you're ready to submit a full referral or want to talk through fit before committing to paperwork, reach out and we'll help you move things forward.