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Billing Forms For Insurance Carrier - Printable Version

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Billing Forms For Insurance Carrier - champmed - 04-14-2016

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!

RE: Billing Forms For Insurance Carrier - 1171 - 04-14-2016

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).

RE: Billing Forms For Insurance Carrier - Timothy Belt - 04-15-2016

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.