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How to bill workers’ comp in California?
To bill workers’ compensation in California, adhere to CA Division of Workers’ Compensation (DWC) regulations. Utilize standardized paper forms (CMS-1500, UB-04, ADA Dental Claim Form, NCPDP) or electronic submission.
Ensure accurate completion of patient information, procedure codes (UBC, ICD), and supporting documentation (DLSR 5021, PR-2). Submit to the claims administrator or electronically via the DWC e-billing platform. Comply with billing and payment guidelines outlined in the DWC Medical Billing and Payment Guide.
Here is the list of some major workers compensation collections steps:
Method: Paper or electronic.
Forms: CMS-1500, UB-04/CMS-1450, ADA Dental, NCPDP WC/P&C.
Data: Accurate patient, provider, injury, service, and code info (ICD, CPT/HCPCS, UB-04).
Submission: Directly to the claims administrator or via a clearinghouse.
Compliance: Adhere to the DWC Medical Billing and Payment Guide.
Electronic: Utilize the DWC e-billing platform for efficient processing.
Payment: Expect delays, appeals, and potential audits.