One simple question can mean the difference between getting paid on a workers’ compensation claim or not. Under LC 5402, when attempting authorization on a workers’ comp claim, always ask if the claim/case is accepted, denied or still in discovery. If the insurance company has not decided to accept or deny the claim then provider can treat the patient without authorization.
Here is the actual code:
(C) Within one working day after an employee files a claim form under section 5401, the employer shall authorize the provision of all treatment, consistent with Section LC5307.27, for the alleged injury and shall continue to provide the treatment until the date that liability for the claim is accepted or rejected. Until the date the claim is accepted or rejected, liability for medical treatment shall be limited to ten thousand dollars ($10,000).
As part of our service to every client, our in-house legal staff at MBC Systems stays on top of the labor code so you don’t have to. Actually we do much, much more: increase your cash flow, make sure that your coding, modifiers, and reports all support billing so that you can get paid, and ensure compliance with all local, state and federal regulations.
“At MBC we understand the business because we are IN the business”
To learn how MBC Systems’ proprietary medical billing system and services can help your practice bill smart, use our contact form or call (949) 863-0022 to set up a one-on-one consultation.
For more information about workers’ compensation billing and collections, click here.