WORKERS COMPENSATION IN MEDICAL BILLING

WORKERS COMP IN MEDICAL BILLING: Workers Compensation denial reasons in denial management
A) If DX code is not related to injury :
Example: R0789- Related to Chest pain.
K5660- Related to Disease of intestines
In this case, after confirmed that the billed DX code is
not related to the injury. We have to remove ‘yes’ mark from
“EMP status” & need to remove the “ACCIDENT DATES”.
ACTION : REBILL THE CLAIM to same payer.
B) If DX code is related to injury :
Example: S99912- Injury of left ankle and S39012A.
In this case, after confirmed that the billed DX code is related
to injury only. Need to bill the claim to WORKERS COMP PAYER.
ACTION: BILLED TO WORKERS COMP INSUARNCE. (EX: State form, All state)
AR in Healthcare : Medical billing
#workers compensation denial reasons
#WC Scenario denial management in medical billing
#what are common causes of injured workers disputing the level of benefits or compensation?
#what is workers' compensation insurance
#work related injury
diagnosis not related to injury
diagnosis related to injury
Changes on EMP status on medical claim form CMS 1500
accidental dates
PR 19 /N418
REBILL THE CORRECTED CLAIM OR CLONED CLAIM
REBILLED TO WORKER COMP PAYER OR INSURANCE
WC
WORKERS COMP : Section 60 of the Workers Compensation Act 1987
BASIC RCM : REVENUE CYCLE MANAGEMENT IN MEDICAL BILLING
DATE OF SERVICE
AR IN MEDICAL BILLING
#Accounts Receivable (AR)
#Accounts Receivable & Denial Management

[@anujsingh-mt8gn]

Very helpful ❤

[@Yogawithrakhi989]

Very helpful sir ☺️

[@PKRVibesCareerGrowth]

@@Yogawithrakhi989 thank you 🤝

[@beautylife9512]

But in case 1 if that particular insurance doesn't cover the patient as commercial what Will we do next??

[@PKRVibesCareerGrowth]

Hi Beauty Life, in this case(if Dx not related to injury) you need to bill commercial payer by Removing the EMP status n accident dates. If commercial payer again denies with your reason (very rare) as non covered services. 1st you need to verify still is there any other additional active commercial payers to bill. If not you can flip to patient with same reason in detail.

[@beautylife9512]

@@PKRVibesCareerGrowth got it thank you so much for valuable time and in time response

[@PKRVibesCareerGrowth]

@@beautylife9512 welcome. Its okay.

[@virenderbhaik3026]

Very fruitful.. i think it’s must to submit MR while billing to WC? Need your confirmation.

[@PKRVibesCareerGrowth]

@@virenderbhaik3026 Not required MR while claim

[@Brunoloveshuman]

How to bill claim to workers comp without member ID

[@PKRVibesCareerGrowth]

Submit with Employer Id, mark the Emp status as yes, put accidents dates. Or Enter SSN in place of member ID.

[@RajeshwariRajbhar]

Sir it a patient is having dizziness , n because of dizzness he felt at work n hot fracture so will it be covered

[@PKRVibesCareerGrowth]

Yes

[@amanshaikh-nw1kf]

Hi sir if the claim needs some correction then we have to submit a CC claim or a fresh one. for like WC, auto liability, veterans affairs and Medicaid?

[@PKRVibesCareerGrowth]

@@amanshaikh-nw1kf need to submit corrected claim with resubmission code 7

[@amanshaikh-nw1kf]

@@PKRVibesCareerGrowth Okay thanks I just got confused coz Medicare even if we make some corrections we have to submit a fresh claim

[@PKRVibesCareerGrowth]

@@amanshaikh-nw1kf only for Medicare we have to submit fresh claims even corrections. Medicare will not accept the corrected claims with code 7.

[@amanshaikh-nw1kf]

@@PKRVibesCareerGrowth Yes got it, thank you

[@TheCalmExplorer77]

@@PKRVibesCareerGrowth I think Medicaid also not accepting Corrected claims.

[@achyuthkumar-ib1cg]

can i get the job as fresher at 31 age in ar calling

[@PKRVibesCareerGrowth]

Yes you can

[@achyuthkumar-ib1cg]

@@PKRVibesCareerGrowth Thank you sir i will start my carrer in AR calling