Medical Billing Forum

Billing => Billing => : stellerdobes June 15, 2018, 03:15:26 PM

: New York Work Comp
: stellerdobes June 15, 2018, 03:15:26 PM
I am in VA and bill for a primary care here in VA so I am use to billing work comp.  My question is how different is billing work comp in New York? 

I have been offered a job with a clinic in New York to do their wc billing only.  Would anyone be willing to let me pick your brain on the difference?

With the wc in VA we print it on a hcfa 1500 send office note to insurance and thats it.  If Im not mistaking with NY don't you have to send something to the state also?  IS this a difficult process?  They have about 20-30 wc pts a week.

: Re: New York Work Comp
: Michele June 18, 2018, 05:11:36 PM
I have not billed for WC in VA, but I do bill for WC in NY.  NY has WC4 forms that can be used for billing, however if you are attaching office notes you can use the CMS 1500 form.  The WC4 and WC4.2 must be used if office notes are not being sent.  A copy of whatever you send must also be sent to the state WC Board as well.  Feel free to post any additional questions.
: Re: New York Work Comp
: stellerdobes June 26, 2018, 07:23:49 AM
Thank you for your reply.  So either form but not both.  Do the insurance require the office note in NY?  In Va they will not pay without them. 
: Re: New York Work Comp
: Michele June 26, 2018, 03:32:00 PM
In NY if you do the form you do not need to include office notes.  The form has specific questions that basically includes what would be in the notes.
: Re: New York Work Comp
: PMRNC July 11, 2018, 07:24:24 PM
We have had to submit notes when requested.
: Re: New York Work Comp
: Michele July 17, 2018, 11:35:44 AM
Yes, us too.  It is not uncommon for them to request the notes.  But technically you do not have to submit them with the C4.  However, it cuts down on rejections to attach the notes with the C4.