|Michael F. Easley, Governor
Buck Lattimore, Chairman
Thomas J. Bolch, Commissioner
Laura K. Mavretic, Commissioner
Christopher Scott, Commissioner
Dianne C. Sellers, Commissioner
Pamela T. Young, Commissioner
|TO:|| All Carriers and Medical Bill Processors
|FROM:|| Buck Lattimore, Chairman
|DATE:|| February 11, 2004
|SUBJECT:||Medical Bills Submitted to the Medical Fees Section
to limited staff and budget restrictions, our Medical Fees Section is
experiencing difficulty processing medical bills that are being submitted with
insufficient or inaccurate information. In addition, bills are being submitted
that should be handled directly by the carrier or processor. The following are
some specific examples and what needs to be done to rectify the situation.
submitted with no Industrial Commission file number. This number is assigned
upon receipt of the First Report of Injury. It is the carrierís
responsibility to ensure that medical processors obtain this number. At no
time should a bill be submitted to the Medical Fees Section without this number.
cannot be processed if they are illegible. It is the carrierís
responsibility to ensure that the bills are legible before they are submitted
unlisted procedures are being submitted without the required medical reports.
These bills cannot be processed. It is the carrier/processorís
responsibility to see that the required information is submitted at the same
time as the bill.
types of bills are processed and paid directly by the carrier. The following
bills should not be submitted to the Industrial Commission: travel, prescription
drugs, ambulance services, out-of-state providers, minor medical bills, private
duty nursing, nursing homes and services paid per agreements (e.g. industrial
rehabilitation, work conditioning or hardening, pain clinics).
are submitting travel and prescription drug reimbursement forms/receipts to the
Medical Fees Section. It is the responsibility of the carriers to advise
claimants of the proper procedures to file for travel and drug reimbursements.
are transferred to a different carrier or third party administrator, you must
provide the following information to our Statistics Section: (1) a list of
claims being transferred with the IC file numbers and (2) the name and code
number for the new carrier or third party administrator.
The limited staff available in the Medical Fees Section and the tight budget make it impossible for us to be responsible for tracking down the omitted information or mailing back incomplete and erroneously filed documents. We strongly solicit your cooperation in ensuring that the necessary information and correct documents are filed with the North Carolina Industrial so that claimants, providers and employers can be well served. Again, thank you for your cooperation in these matters.