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Billing Forms For Insurance Carrier
Does anyone know what specific form(s) insurance needs from an M.D.'s office for medication dispensed to a work comp patient? Is it just the patient's info with the claim # and insurance info, or is there an actual form to use for billing in each state? I work with Dr.'s and patients, I've heard there's a form that can only be sent via traditional mail, and that's about it. Any insight here would be appreciated, thanks a lot!
I suspect that each state and each insurance carrier is different. Most state work comp boards don't specify a particular form for meds dispensed by a physician.
most states do however have a fee schedule that may control under what circumstances and what may be charged for physician dispensed meds.
you would have to check with the individual state for their fee schedules.
P.S. there are three states where physician dispensing is prohibited in general (Massachusetts, New York, and Texas).
"Footer/signature" used in all my posts:
........Each state has their own comp system. We need to know which state the claim was filed in to provide accurate information.........
Recently there have been some changes at least in PA that to the best of my understanding require that an original script (no faxes or e-mails) be used with a Schedule I-III controlled substance, but I do not know the details or whether this is just PA or nation wide.
Timothy D. Belt
DISCLAIMER: This post is intended as general information applicable only to the state of Pennsylvania. The answer given is based only on the facts provided. This post is not intended to create an attorney client relationship, or to provide any specific guarantee of confidentiality.

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