Workers Comp global period????????????

meggie

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I was recently informed by an adjustor for a patients worker's compensation that the global period only applies to private insurance. Does anyone have any experience with this? Any and all help is greatly appreciated! :)
 

mdarling

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I am in NYS. Our Workers Compensation book has the global periods in them. 99% of the time it follows the normal A/C periods.
 

meggie

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That's what I was thinking, but being that it was an adjustor who told me otherwise, I have to find out for sure :) Thank you :)
 

bertrandr

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Global Periods in Workers Compensation

I am a licensed adjuster in Arkansas, but have adjusted claims across multiple jurisdictions. I'm currently the manager of a managed care company in their bill review department. I'm curious to know if the adjuster is auditing the bills or whether they are using an bill review company. In my experience, with today's technology, adjusters are not performing the bill review.

The rules and regulations for Medical Cost Containment in Workers Compensation is governed at the state level. Most states have fee schedules in place that address global periods. Where things can get a little more complicated is whether or not your particular state doesn't have a formal fee schedule and UCR (usual, customary and reasonable) is what is utilized to reprice bills. In these UCR states, AMA guidelines are still the industry standard but are not necessarily mandated or governed by the state.

I suggest that you call the bill review company that processes their bills. They would be the source for information concerning how bills are processed.

If you let me know what state the injury occurred, I can send you a link to that state's rules and regulations.

Good Luck,
Rhonda Bertrand, BA-HCA, CPC, AAPC Fellow
Manager of Claims Processing, National Comp Care
 

pyoung4609

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Global Periods for OH

In Ohio BWC has global days the max is 60 days so if it normally has 90 it defaults to 60
 
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