A State Specific Coverage Medicaid provides health coverage to nearly 64 million Americans. This number includes eligible low-income adults, children, pregnant women, the elderly, and those with permanent disabilities. The chances of your clinic having a Medicaid beneficiary walk through your door is quite possible. The challenge is, no two states are alike, and coverage…
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Reference Documents In this module we discussed some of the specific forms that may be required for federal injury claims. Listed below are sample forms that are common when requesting medical authorization as well as directions on billing procedures. As always, we recommend that you check the carrier website for the most current versions. CA-16…
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Frequently Asked Questions- Workers’ Compensation Q: I contacted a patient’s employer and was told that I must contact the MCO handling the case – what is a MCO? A: A Managed Care Organization (MCO) is a private company that an employer selects to medically manage the workers’ compensation claims for injured employees. MCOs are often…
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Support Tool Once a clinic has determined the type of coverage and located state and federal online provider resources, it is time to verify the benefits. Although the state and federal website portals offer great resources when it comes to manuals and forms, they do not provide the information necessary to ensure reimbursement for the…
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This tutorial will provide a nice overview of the difference between state and federal workers’ compensation. It provides the resources a clinic needs to track down state related workers’ compensation resources. It will also cover how chiropractic coverage can be confirmed and authorization for treatment obtained. Since verification is the only way to confirm that…
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Identify the Type Verification of Workers’ Compensation coverage starts with identifying the patient’s type of coverage. Is it a state or federal plan? This often depends on the type of employer. If the patient’s place of employment is a federal business, it is more than likely you will be dealing with one of the Office…
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