The treatment of an injury at work is not simply a clinical process, but rather a process of submitting a claim with documentation, rules of authorization, and different claim requirements from different payers, which is unlike commercial billing. Even if everything is done right, if the body part is coded wrong or the causation note is not clear, payments can be delayed for months. With lots of patients on the books, it is hard for providers to keep an eye on every claim and prevent denials. Getting reimbursed consistently depends on doing WC billing correctly from the first submission, not fixing errors afterward. Practices that prioritize accuracy upfront see fewer disputes.
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