How Physician of Record Issues Can Impact a BWC Claim
Recently, HealthCare for Business had a patient who was injured on the job and had a specialist recommended he have a holter monitor done. A holter monitor continuously records a patient’s heart activity (ECG) for 24 to help his or her physician correlate symptoms of dizziness, palpitations or black outs.
The patient did not have a Physician of Record recommend the test, instead it came as a recommendation from a (cardiac) specialist. Unfortunately, after the holter monitor, the C-9 was placed retro actively and was denied, leaving the patient responsible for the total bill.
Medical specialists typically do not handle many BWC patients, resulting in forgotten or incorrectly filed C-9 forms. Additionally, C-9 forms are no longer able to be put in retro-actively, eliminating the chance of payment on services with missed or inaccurate BWC authorizations.
The Importance of the Physician of Record for Correct BWC Claims
As a BWC Certified health care provider, HealthCare for Business manages many worksite employee injury claims. A frequently mishandled area is the Physician of Record or POR which causes delays or snags in the BWC claim process.
When a worksite injury occurs, the employee may see any doctor for the first visit. After the initial visit, they must select a BWC-certified provider as their physician of record (POR). A BWC claim can only have one POR and that person must be a medical doctor.
After the POR has been established and documented, the patient can then have many treating providers. It is best to have your POR coordinate all of the services with your treating providers both for coordination of care and to ensure all paperwork is properly completed. HealthCare for Business has strong working relationships with specialists in the Lake and Geauga county area and our BWC Coordinator is constantly in contact with these offices when working with our BWC patients.
As in the case of our office, the in-house BWC Coordinator always requests that physicians complete the C-9 with the proper codes and procedures. The form is then sent to us so we can ensure all the necessary information is correct before it is submitted. We have a C-9 tracking system for everything we place and follow up on a weekly basis.
If you choose a POR that doesn’t handle many BWC cases, it’s still very possible that forms aren’t getting placed properly or in a timely fashion.
HealthCare for Business will act as the Physician of Record (POR) and understands that the position is of extreme importance to the injured worker and you, the employer. When your employees designate us as the POR, we coordinate and communicate with all treating providers and are the contact for the employer for all medical concerns.
For more information on all HealthCare for Business BWC services, contact our office at (440) 354-4747 or email us.