Medicaid is similar to Medicare in the sense that a provider must enroll* with the (in this case state) program as a provider to be able to bill Medicaid patients. This can be confusing when a payer with which your clinic is contracted (e.g., Anthem or UHC) manages the Medicaid coverage in your state. You…

Medicaid provides health coverage to around 80 million Americans including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. Medicaid is administered by the states in accordance with federal requirements. State and Federal Governments fund the program jointly. The Rapid Tutorial titled What is Medicaid provides an overview of the basics of…

Download Reference Documents Documents related to federal Workers’ Compensation are available in this training module. If you need assistance with your state, please locate the clinic’s local bureau. You can find a list of state contacts at:  https://www.dol.gov/agencies/owcp/wc Remember, in order to treat patients covered by Federal Workers’ Compensation, providers must enroll with the Department…

Worker’s Compensation FAQs Q: How does the office determine what type of workers’ compensation claim to file (e.g., State or Federal)? A: By asking where the patient works.  If they tell us they work at the Post Office, the chiropractic office staff gathers information to bill Federal Workers’ Compensation. If the patient indicates s/he works…

HIPAA Allowed Disclosures in Workers’ Comp The HIPAA Privacy Rule does not apply to workers’ compensation insurers, workers’ compensation administrative agencies, or employers except to the extent they may otherwise be covered entities. However, The Privacy Rule acknowledges the need for insurers and other entities involved in the workers’ compensation systems to have access to…

Making Workers’ Comp Cases Successful The core aspects that lead to successful workers’ compensation cases are early identification, authorization, documentation, appropriate coding, and billing. Early Identification You must have procedures in place to identify patients with work-related injuries for which they are seeking treatment before treatment begins.  Pre-treatment authorization is often required for patients with…