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Most Recent Articles
May 14, 2014
2 min read
0
Confusion Over Work Comp Clearinghouses and Bill Review Companies
Claims Administrator: Employers Compensation Insurance Company Issue: Confusion over Employers’ clearinghouses and bill review companies Status: Open
Apr 29, 2014
2 min read
0
Sedgwick Denying Bills with Incorrect Adjustment Reason Codes
Claims Administrator: Sedgwick Claims Management ServicesIssue: Inaccurate Adjustment Reason Codes contained in Sedgwick’s EOR denialsStatus
Apr 28, 2014
1 min read
0
Changes to OMFS: Pharmaceutical, DMEPOS, and Physician Fee Schedule
The DWC passed major changes to the workers’ compensation fee schedules, affecting reimbursements for pharmaceutical NDC numbers, DMEPOS, and splinting and casting Q codes. ...
Apr 28, 2014
1 min read
0
Liberty Mutual Incorrectly Denying Bills Using Explain Code B649
Claims Administrator: Liberty MutualIssue: Incorrect denial of billsStatus: OpenDescription: Recently, claims administrato...
Apr 28, 2014
1 min read
0
How Electronic Billing Works, Part II
Last time, we covered: What happens after providers hit "send" when transmitting electronic bills Why electronic bills get denied This time we discuss wh...
Apr 25, 2014
2 min read
0
More Workers' Comp Fee Schedule Changes
The DWC passed changes to the workers’ comp fee schedules, affecting:Pathology and clinical laboratory feesRelative Value FileCCI EditsMedi-Cal Ph...
Apr 24, 2014
2 min read
0
How Electronic Billing Works, Part I
If you’ve ever sent an email, you already have a general understanding of how workers’ compensation electronic billing works. So we’re going to use what you already know abo...
Apr 23, 2014
1 min read
0
New CMS 1500 Form
Starting April 1, 2014, providers in California must use a new CMS 1500 form when submitting bills for treatment provided to injured workers. The transition period has come ...
Apr 22, 2014
1 min read
0
Electronic Billing Timelines
One of the greatest benefits of electronic billing for workers compensation is how much it speeds up the whole process. In addition, work comp e-billing helps with making sur...
Apr 19, 2014
1 min read
0
Electronic Billing in a Nutshell
THE LAWThe electronic billing mandate is a statute that's in the Labor Code, as Title 8 of CCR: Sections 9792.5.1(b), 9792.5.2(c) and 9792.5.3(b).In effect sinc...
Apr 16, 2014
1 min read
0
The Benefits of Acknowledgement Protocols
For workers' comp medical e-bills, acknowledgement protocols are designed to catch the following billing errors before review by a claims administrator: e-Bills submit...
Apr 15, 2014
1 min read
0
Electronic Billing Compliance for Claims Administrators
In California, electronic billing has been mandated for workers compensation medical bills since October 18th, 2012. For claims administrators, this means that you mu...
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