OMFS
May 2, 2018
DME: Invoice Not Required for (Most) Durable Medical Equipment
Too often, we see claims administrators demand extraneous paperwork from providers, adding unnecessary friction to the workers’ comp billing and payment process. One example ...
Apr 13, 2018
“By Report” Billing Codes: Best Practices for Proper Reimbursement
When the Official Medical Fee Schedule (OMFS) assigns the reimbursement for a procedure code as “By Report” (BR), establishing the correct payment amount is one of the tricki...
Apr 6, 2018
Interpreter Fee Schedule: An Imperfect Step in the Right Direction
California’s Division of Workers’ Compensation (DWC) proposed new interpreter fee schedule regulations this week. The changes would create a uniform fee schedule, replacing t...
Apr 4, 2018
CA Physician Fee Schedule Update Adds New Billing Codes, NCCI Edits
A new order from the Administrative Director of California’s Division of Workers’ Compensation (DWC) updates the Physician and Non-physician practitioner services portion of ...
Mar 30, 2018
Location-Based Reimbursement in CA? DWC Plans Hearing on OMFS Changes
California workers’ comp providers may soon face another layer of complexity in calculating reimbursements: Geographic Practice Cost Indices (GPCI), which would raise or lowe...
Mar 15, 2018
Outpatient/ASC Fee Schedule: DWC Issues (Then Corrects) Reimbursements
The California Division of Workers’ Compensation (DWC) ordered new adjustments to the Official Medical Fee Schedule (OMFS), effective March 15, 2018. The orders update fees f...
Feb 21, 2018
Reminder: E/M Reimbursements Higher in 2018
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*Some of the most commonly used billing codes by our providers, Evaluation an...
Feb 15, 2018
How to Bill for Physician-Dispensed Pharmaceuticals
Payments for physician-dispensed drugs are some of the most misunderstood — and incorrectly denied — in workers’ compensation billing. Too often, the employer or insurer’s cl...
Feb 13, 2018
Providers: Don't Accept 2017 OMFS Rates for 2018 Dates of Service
Lately, we’ve noticed a problem. Some claims administrators are reimbursing providers incorrectly. Instead of paying the higher 2018 Official Medical Fee Schedule (OMFS), cla...
Dec 23, 2017
2018 Radiology Reimbursements (Professional Services): Cheat Sheet
Lately, we brought readers the Division of Workers’ Compensation (DWC)’s recent updates to the Physician fee schedule for evaluation & management and surgery. Today, we take ...
Dec 20, 2017
2018 Surgery Reimbursements: Cheat Sheet
2018 is around the corner, and the Division of Workers’ Compensation (DWC) recently posted updates to the Official Medical Fee Schedule (OMFS), effective January 1. La...
Dec 15, 2017
2018 E/M and Other Services Cheat Sheet
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*It’s that time of year: the DWC recently announced changes to the reimbursem...