Worker Compensation Billing

Tgarner2016

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I need some direction on workers compensation billing. When a workers comp claim is denied by the insurance company, can someone tell me what steps they take after this. The claim is denied as non work related injury which is obvious it was not.
 
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I'm a bit confused on what you're asking. Are you saying that the reported injury was determined not to be work-related and therefore would not be covered by the WC carrier? If a person injures themselves and it's determined the employer is not liable for the injury, then the patient's health insurance would be billed.
 

CodingKing

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Unless it was denied becasue it was work related but patient didnt follow workers comp reporting guidelines the answer would be different. Not work related is no different than accidentally sending to the patients previous insurance and denied as not eligible. You just bill the proper carrier. Attach the denial if its going to be a timely filing issue.
 

MarcusM

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For a compensable work injury, the treating doctor must use the correct compensable diagnosis code. For example, if the accepted compensable injury is lumbar strain, but the claim has the primary diagnosis code of lumbar radiculopathy as the primary diagnosis, then this claim will be denied.
 
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