1. Collect Information before starting treatment
Injury claims are persnickety. For everything to go smoothly, accuracy and promptness are key. Before your patient’s first appointment, collect the name of the insurance carrier, date of accident, claim number, employer name, and contact information for the claims adjuster or case manager. The carrier may request additional data as well. Provide it promptly.
2. Always Confirm Coverage
Call the insurance carrier before treating the patient. They won’t guarantee coverage, so find out if they will accept claims for consideration. Confirm that the claim is open, ask if treatment will be considered, and see if a deductible applies. Collect the claims mailing address, too. Remember to ask about prescription, referral, or preauthorization requirements.
3. Document EVERYTHING
No documentation, no payment! Your SOAP notes should accurately reflect all areas of treatment. Include procedure codes, chart progress, diagnoses, and a summary. When you’re billing time-based procedure codes, be meticulous. It matters!
4. Follow the Rx
Many injury claims require a prescription or referral for alternative care. To avoid denied claims, follow instructions carefully and stay within your scope of practice.
5. Only bill companies that will reimburse for your services
Seems like a no-brainer, right? This is why it’s important to call beforehand. Avoid frustration and lost payments. Bill smart! Even if you’ve billed the carrier before, include a signed W-9 with the first claim. Make sure your billing address and EIN are correct. MVA, WC, and PIP cases require printed documentation via mail or fax. Acubiller clients: We charge minimal fees to cover mail/print costs. Refer to our Fee Schedule for more information.
6. Use the correct form and most current codes
To explain the nature of the injury, accident claims require “external injury codes”. Under ICD-9, these codes began with the letter E. Under ICD-10, the external cause of morbidity codes begin with V, W , X, or Y. Find out which codes apply for your state and situation and bill with care.