Wiki Workers Comp Billing

jviggiani

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Hey Everyone!

Are there any Workers Comp specialists out there who can tell me when it is okay to bill a patient's health insurance when they have an active worker's comp injury we are threating them for other than an unrelated injury? Can we bill their health insurance for the work related injury as secondary at any time? I just received word we were told other specialties are billing health insurance secondary to workers comp insurance. Please help!!

Thanks
 
I"ve never heard of billing a personal insurance secondary to WC as the WC pays quite well compared to other payers. We are billing personal insurance for non related industrial problems and creating two encounters and notes.
 
Why would you bill anyone secondary to workers comp when there is no balance left after workers comp processes?

You can always see a patient for a non-industrial injury under their health insurance. It is best to do it on two separate days, just to keep all the notes clear and separate on industrial vs. non-industrial treatment.
 
Agree with the other 2 comments. There would be no balance to bill as secondary, plus whatever WC pays you are accepting that payment as payment in full for that service. You would only bill their private insurance if they are bein seen for something go unrelated to their WC claim.
 
Yes but there is no guarantee they will pay as they will require accident details etc from the injury. WC should cover everything has long as the diagnosis for the visit is the approved diagnosis for the approved WC claim.
 
Hi There:)
The WC claim can be filed and documented the same day as if the patient got treated for a chronic condition and work injury. However at my old medical center we would have the doctor do 2 outpt reports/claims for same patient to support the one WC diagnosis and the other diagnosis of chronic condition .All our doctors were certified/credentialed under the state WC agency also. And in this circumstance the patient was being treated by their family doctor who was also the WC approved physician. All med record documentation, coding and personal insurance billing for the chronic conditions and the WC claim was done on separate claims if done on same day.
I hope this information helps.
Lady T
 
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