Medical Billing Forum

General Category => General Questions => Topic started by: Trisha Reyes on September 06, 2008, 10:02:34 AM

Title: workmens comp
Post by: Trisha Reyes on September 06, 2008, 10:02:34 AM
what is the acronym IME  I think it has something to do with a denial and the pt. reaching the maximum medical improvement, but the dr. continues to treat because he does not agree that the pt. is fully recovered.
Title: Re: workmens comp
Post by: Michele on September 06, 2008, 04:08:41 PM
IME stands for Independent Medical Exam.  If charges are being denied due to IME, that means that the Dr who performed the IME felt that the patient reached maximum medical improvement, or at least that further treatment would not be beneficial.  If the treating Dr disagrees, they can continue to treat.  The patient needs to get a lawyer and have a hearing.  The judge will either side with the independent medical examiner or the treating dr based on the evidence.  If the treating dr continues to treat they should submit notes and any other supporting documentation so when the hearing comes, the information is available.

Michele
Title: Re: workmens comp
Post by: LW5689 on October 06, 2008, 05:40:47 PM
Hi Michele,
I have been reading your "Secrets to Signing Up Your First Doctor."  Its great!  I have a question regarding something I read regarding filing a worker's comp. claim.  I recently sent out a wc claim for a provider but I did not send a copy to the wc board.  The provider said that he has never done that before.  Is that policy still in affect?  Thank you.
Title: Re: workmens comp
Post by: Michele on October 06, 2008, 07:46:35 PM
Absolutely.  That provider is lucky.  He must not have had many or any patients that have gone to a hearing.  Everything is online now and lawyers for both sides look up claims to get info to use while in front of the judge.  It is very important that a copy of all WC claims filed get sent to the board.  If a patient is being treated and goes to a hearing, but no claims were filed that could seriously jeopardize their case.

Michele
Title: Re: workmens comp
Post by: LW5689 on October 07, 2008, 09:42:34 AM
Michele, Thank you so much for that clarification.
Title: Re: workmens comp
Post by: mickeyss on January 16, 2009, 08:00:21 PM
Hi Michelle,
 I am new to Chiropractic billing. Please explain the sending a wc to what board. I am in Texas. Thank you Mickey
Title: Re: workmens comp
Post by: Michele on January 17, 2009, 08:35:19 PM
Whenever you submit a claim for workers' comp you have to send a copy to the comp board for your state (in addition to sending the claim to the carrier for payment).  If you go on the workers comp website for your state you should be able to find the address that you need to send the copies to.

Michele