BILLING
AultComp MCO must process all bills within 7 business days of receipt from the provider. Fee bills are reviewed proactively by on-site certified coders prior to processing for payment.
Things to think about when submitting bills:
PAYMENT FOR SERVICES
Resourceful Links:
BWC Fee Schedule
BWC Billing and Reimbursement Manual
AultComp MCO must process all bills within 7 business days of receipt from the provider. Fee bills are reviewed proactively by on-site certified coders prior to processing for payment.
Things to think about when submitting bills:
- Confirm medical documentation is attached to bill
- Does total time listed on documentation match units billed for time based therapies?
- Does the primary billed diagnosis match what is being treated?
- Authorized C-9's is for the requested services and is not a guarantee of reimbursement for any specific CPT code(s). Reference OAC 4123-6-16.2
- Reimbursement is based on claim status, clinical edits, national coding standards and supporting medical documentation in accordance with BWC Rules. Reference OAC 4123-16.2
- BWC Global surgery packages are 60 days
- Is the itemized statement attached for inpatient bills? Is the itemized statement attached for outpatient bills?
- Any questions or concerns, please contact our billing department
PAYMENT FOR SERVICES
- A C-9 treatment request must be reviewed and approved by members of the medical management staff before a bill can be paid to a provider
- The medical bill is reviewed for treatment approval, correct coding, medical necessity, medical relatedness, and cost effectiveness
Resourceful Links:
BWC Fee Schedule
BWC Billing and Reimbursement Manual
