Calif. work comp claim completion changes

There were some changes made a few months ago as to how claims are filled out specific to California Worker’s Comp billing only.  Relative to a CMS1500 claim form, box 1a no longer has the claim #, instead it has the patient’s social security # or, if unknown, 9-9’s (do not enter dashes in either case).  In box 4, goes the name of the employer.  This actually makes sense because they are the insured, the patient is the beneficiary.  Of course you would check the box 8 status as OTHER.  Then, in box 11 is where you put the claim # for the work comp case.  If you have have an authorization #, you should always enter it in box 23.  Then, on the newest claim form version in box 24j, you will see a top and a bottom; the top is shaded, the bottom is not.  In the top box now goes the TAXONOMY code for acupuncture, this is: zz 171100000x and in the box beneath it, next to NPI, goes your NPI number.  If you belong to a group, you would use your individual NPI here and then the group NPI in box 33a below. These are the only changes to how the claim form is completed, all other instructions we’ve given in the book on how to complete a claim , etc. still apply except for what was indicated above.  Happy billing!

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6 Responses to Calif. work comp claim completion changes

  1. Tracy Ye says:

    Soooo helpful information. I mailed CA work comp 1500 form September last year, and they mailed me back on Jan this year and said that all the paper should be typed, so I have to spend $100 to buy a type-writer.. And I didn’t get a penny after I mail the typed 1500 form again on Jan.. Really don’t know what I should do here. As Tiffany said before , I should keep calling their adjuster every day!!!! And they changed my patient’s adjuster twice within 6 months!

    I printed the above information written by Tiffany and put it on the front page of my Work Comp folder.

    Thank you again!

    • tandersen says:

      Hi Tracy. Maybe you should look into, they have a free on-line billing tool that you could, at least, type your information into and generate a claim form. I believe it then keeps a record of the patient so that next time you bill, you can click on the patient and the info will again populate for you and all you have to do is add/change the dates of service. It can also perform electronic billing, for your non-work comp claims (in California at least) resulting in faster payments and better submission tracking. Something to definitely look into, they are very helpful in getting you set up and it is free!

  2. tandersen says:

    I found a CMS 1500 PDF on-line that you can just type into and then print out onto a claim form…you could try this too! Here’s the website;
    You can also save the PDF template to your computer so that you don’t have to download it each time and then you have it to fill in whenever you need it.

    • Tracy Ye says:

      Dear Tandersen,

      You are not only a saver for my clinic billing, but a super pain-free pill to treat my insurance billing panic!!! Love your link and information about this free template 1500 Form. Instead of spending $100 for that typewriter, I should pay you this $100 for this invaluable information. I already download it and will use it again and again!

      I do suggest that you can combine this free template with your 2nd edition of your book!

      Millions of Thanks and love your website!!!

      Tracy Yeah!!!!! 🙂

  3. acuman says:

    what is a reasonable amount of patients to see per hr when doing comp work? with 3 beds available and one practiconer

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