NC Industrial Commission Delivers on E-Billing and Electronic Payment in Workers Comp

The Industrial Commission (IC) has announced that it will require carriers and providers to develop and use electronic billing and payment processes in the administration of workers’ compensation claims. The IC announced its unanimous and long-awaited decision in Minutes released on June 14, 2011.  The Minutes cite access to care for workers’ comp patients, reduced administrative burdens, consistency with national standards for electronic health care transactions, and increased overall efficiency in workers’ comp as the reasons behind the new policy. The IC will be developing agency rules to implement the requirement.

For years, the NCMS has worked tirelessly to simplify workers’ comp claims submission and payment processes for physician practices. Tuesday’s announcement marks a big step toward that ultimate goal. 

NCMS also anticipates that the rules will also resolve the “ICD-10 dilemma” facing the workers’ compensation system: federal regulations that require medical practices to adopt 5010 and ICD-10 do not apply to entities that operate in state workers’ compensation systems (such as the Industrial Commission and work comp insurance carriers). So as most of the health care industry made the transition, medical practices treating workers’ comp patients would be forced to operate in both the 4010/ICD-9 realm and the 5010/ICD-10 realm. But this week’s developments will hopefully eliminate that scenario. 

As part of the process, the IC will also be upgrading its systems to include an electronic data interchange (EDI) interface, allowing it to receive medical billing information when appropriate.

The NCMS and its IC Task Force wishes to thank Commissioner Staci Meyer for her commitment and dedication to this effort. Commissioner Meyer worked closely on the project with the NCMS, medical group managers, and workers’ comp carriers, and successfully gained the support of the other five members of the Industrial Commission.


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