Can anyone offer any advice regarding Work Comp patients who's claim has gone to litigation? Our practice is an orthopedic practice in the Philadelphia area. One of our docs sees a lot of work comp patients. Typically, the patients private insurance is billed until the work comp case settles. However, I'm seeing it more and more where we find out that the claim has settled when the private insurance retracts their payment. Patients don't always supply attorney information for us to reach out to the attorney and many times we never receive a request for billing info from the attorney. Once the private retracts, we're left scrambling to a) contact the patient for info b) leave message after message for the attorney with little luck. There has to be a more efficient, pro-active way to handle this from the beginning to save our selves time & aggravation. Any advice or suggestions are appreciated.
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Wiki Work Comp Litigation
- Thread starter Amycb105
- Start date
mitchellde
True Blue
You should not bill commercial insurance for work comp cases. This needs to be determined at the first encounter whether this is work comp. each state is different for work comp so you need to find out in your state how work comp cases are to be submitted. Most of the time there are set carriers for these claims. You submit the claims through that designated carrier.
Private insurance is billed AFTER a denial is received from the work comp carrier. Typically we find out that a claim has gone to litigation once those denials are received. (assuming the diagnosis for treatment was paid in the past) If an attorney is listed in the patients demos we reach out to them. However, many times a patient doesn't provide attorney info OR they begin treatment without one (not realizing that their WC is going to fight their claim).
MARY K
Networker
workers comp
In New York state at our practice when the carrier denies and case goes to litigation, we must hold claim until The Workers Compensation Board rules, the if decision is found in favor of carrier we then bill pt's private insurance w/copy of denial.
In New York state at our practice when the carrier denies and case goes to litigation, we must hold claim until The Workers Compensation Board rules, the if decision is found in favor of carrier we then bill pt's private insurance w/copy of denial.