Billing for Workmans Compensation

[despina1118]

I am a transcriptionist and have a billing/coding question. I work in Florida.  While discussing transcription with the staff at an urgent care office yesterday, their records manager stated that all documentation must be available for billing within 24 hrs of the pt encounter.  She stated that 24 hrs is a mandatory Federal requirement of workman's comp.   If this is true then the majority of this practice's transcription jobs will be STAT jobs - which they refuse to pay stat rates.   I called the Dept of WC in Florida and the respondent did not have the answer.  He suggested an email to another division of Florida Dept of State Workerman Comp but I am afraid their response will take along time to receive.  This clinic is considering our proposal for transcription, but much hinges on this 24 hr workman's comp issue.  Thank you in advance for your help and comments.  This is an awesome website - I've learned much reading these posts!   Thanks again,   

-Debbie

[despina1118]

Sigh - no responses.  I thought for sure you all would know the answer.  Perhaps I didn't pose the question correctly - so I'll try again.
Does Workman's comp require the billing service to submit the encounter form within 24 hrs of seeing the pt - or is this just "office protocol" and they're blaming the State? 

[PMRNC]

I am thinking she is confused and mixing up the employers obligation to report within 24 hours. I could find nothing about having to have the billing done w/in 24 hours, that's absolutely crazy. What I did find was references to "statute of limitations" but that's not going to be a day or even a week. LOL
Anyway to be sure you can check here: http://www.fldfs.com/wc/
And again, the only thing I could find was the employer was responsible for filing the ROI within 24 hours

[Pay_My_Claims]

I haven't heard of that either Linda. I'm in NC, and its not a policy here, but I can't speak for anywhere else. If they have that rule, then they need to enroll in PSYCH care!!

[Michele]

I was confused between the transcription and the billing.  I wasn't sure if you were asking if the transcription had to be done within 24 hours, and I'm not familiar with any transcription requirements.  In NY, a provider has up to 15 days to file the initial claim and 45 days for followup visits.  You should check the laws for your state, but it sounds like a preference.  Anyway it will be a problem for you if that is the way they want it done.

Good luck
Michele

[despina1118]

I apologize for the confusing post. Thanks so much for your responses.  After much researching I found that it is the employer and not the clinic that must report the claim immediately (24 hrs).   I agree PMRNC - I think she is confused. 

The medical director and I discussed all this in detail - and I explained your discussion board and the answers you provided to my inquiry.  I'm happy to report I did get this client's transcription business.  However, he's now questioning the credibiilty and knowledge of his in-house billing dept. I'll let you all know if he decides to oursource billing services too.  Thanks again!    

[Pay_My_Claims]

Great research!