Begin Claim Process- It is in the interest of a first health provider to begin the claim process by filing the Worker and Physician’s Report of Industrial Injury with the Industrial Commission of Arizona.
Check the Status of the Claim- Periodically check with the patient/injured worker to see if the claim has been “accepted" or “denied" by the insurance company, which typically occurs within one month from the date the claim is filed. If the patient/injured worker is unable to provide the information, contact the Industrial Commission at (602) 542-4661 to determine the status of the claim.
Follow Industrial Commission of Arizona Fee Schedule- It can be financially costly to continue treating a patient with a denied claim. However, once the claim is accepted, you must bill pursuant to the Arizona Industrial Commission Fee Schedule
Claimant Not Responsible for Disputed Amounts- Keep in mind that the claimant/injured worker is not responsible for payment of any disputed amounts between the medical provider and the insurance company.
Bill in Proper Format and Timely Manner - Medical office staff must provide billing to the insurance carrier in proper format and within a timely manner.
Must Bill Within 24 Months - The doctor’s office should bill the insurance carrier periodically and throughout treatment. Do not wait more than the 24 months from the last service, or the bill will not be paid.
Bill During Ongoing Litigation – Do not wait until there is some finality to the litigation before you bill. It could be over two years before it is final.
Always Send Bill- Let the bill be rejected and then send it back. At least there will be record that the bill was sent and the service was properly billed during the statutory two-year period.
Robert Wisniewski, Esq. has the experience and skills necessary to help injured workers through the claim process. When a doctor's office has questions, he can provide information to ensure that all services are considered for payment. Contact The Law Office of Robert E. Wisniewski at (602) 234-3700 to schedule a free consultation.