WC and Car Crash Billing...

[Minimole]

We picked up a great new account billing for a neuro-psychologist recently; however, we have never submitted claims for either workers compensation or car crashes.  Can anyone offer some advice?  I understand the report completed by the neuro-psychologist needs to be attached to the claim(s).  I assume they should both be on a CMS1500.  Is there anything else we need to know other than the obvious need to check the appropriate situation in Box #10?  Thanks!

[Michele]

Workers Comp rules vary by state.  In NY you can submit claims either on a WC4.2 or on a CMS1500 with the notes/reports attached.  I'm not sure if your state is the same.  Auto claims are submitted on a CMS1500.  Many carriers require the notes/reports attached as well.  The timely filing for auto/workers' comp claims is 45 days.

[Minimole]

Thanks, Michele...especially about the 45-day timely filing requirement.  We are in NJ.  Also, I noticed in CAQH there is an area to include a Workers Compensation #, just as they have an area for a Medicare PTAN# and Medicaid ID#.  Is there some type of process the provider needs to go through in order to be issued a Workers Compensation ID # before they take on these cases?

[Michele]

I'm not sure what state you are in but I would contact the state workers' compensation board and ask.

[PMRNC]

Every state is different. I have done some no-fault and WC for NY/NJ/CT and MD   IN MOST cases there is already a case open so you really don't have to do a LOT of work but I have staff get case #, attorney info, DOI, and adjusters name. MOST already established cases have all of that info already so you just verify the informtion like you would an insurance verfication. The only time it gets a bit involved is if your client is in beginning process of a new case. Because I do mental health a lot of claims are held up to verify it's part of the specific case so we usually send a letter to attorney (LOP) to assure payment regardless. Your provider is probably dealing with head/brain injuries so it will probably be a lot more cut/dry Just call your WC board in yoru state, but usually you can get a LOT of the info from hospital face sheets, ER or hosp so you are not on a scavenger hunt and patient isn't able to get you info.

[Michele]

I'm not sure what state you are in but I would contact the state workers' compensation board and ask.

   Just realized you said NJ right in your post!  Sorry. 

The CMS 1500 should be fine.  As for putting personal info in the mail, it is a federal offense for anyone other than the person/business that the mail is addressed to, to open that mail.  Other than sealing the envelope properly, and addressing it carefully, there is not much more you can do.  Don't put in anything not needed, but there is really no way around mailing PHI.