Depending on the state where the employee works the forms will vary. In many states, the employees use the CMS-1500 claim form to submit workers’ comp claims.
In New York State, workers compensation is handled by NYS Workers’ Compensation Board which is a government agency that approves and handles all workers’ comp-related claims. As of October 2019, NYSWCB accepts electronic billing for all claims, however, ink signatures are still required on the majority of forms. (NOTE: Ink signature requirement has been waived during the Covid-19 pandemic.)
The adjuster revises medical bills according to the carrier’s fee schedule. Providers aren’t allowed to bill patients for any remaining balance on workers’ comp claims. Providers also agree to accept the fee schedule rates as payment in full, since workers’ comp doesn’t typically include co-insurance or co-payments.