Workers’ Comp

The North Carolina Industrial Commission and the state’s workers’ compensation system are entering a time of significant transition. Check back often for the latest news and for resources that will help your practice navigate these changes.

Administrative Simplification for Practices

These rules will:

  • Require electronic billing and payment
  • Standardize the medical documentation that accompanies your claims to carriers;
  • Require carriers to accept 5010 transactions and ICD-10 diagnosis codes.

Also read: “NC Industrial Commission Delivers on E-Billing and Electronic Payment in Workers Comp”

Also read: “NCMS Efforts to Secure E-Billing Mandate in Workers’ Comp Gets National Attention”

E-Billing Deadline July 1; Are You Ready?

The shift to electronic medical billing and electronic payments in the workers’ compensation system will take effect just a few weeks from today on July 1, 2014.

The Industrial Commission has its North Carolina Workers’ Compensation Electronic Billing and Payment Companion Guide, which provides specific technical guidance to stakeholders for how these electronic transactions (and the data they contain) should be exchanged.

As part of its e-bill initiative, the Commission has also taken the bold step of officially adopting the CAQH CORE Operating Rules for electronic funds transfer and electronic remittance advice (EFT-ERA).  Under these rules, which will be phased in January 1, 2015, carriers must offer a standard EFT enrollment process and make payments via EFT-ACH at the practice’s request.  To our knowledge, North Carolina is the first jurisdiction to specifically incorporate these rules in the context of workers’ comp.

The North Carolina Medical Society (NCMS) applauds the Industrial Commission for its commitment to streamlining the medical billing process in workers’ compensation, and for its willingness to consult with the NCMS and other industry stakeholders on this project.

NCMS Holds E-Billing Webinar for Members


Latest Workers’ Comp News

News from the Industrial Commission

  • OFFICIAL NOTICE: Updates to the Medical Fee Schedule Effective January 1, 2013 (PDF)
  • NCMS Secures Historic Doc Pay Increase in Workers’ Comp Starting in 2013, physicians will be compensated more fairly when they provide care to North Carolina’s sick and injured workers. Physicians will see a 30 percent increase on new- and established-patient office visits (CPT codes 99201-99205 and 99211-99215) and a 5 percent increase on all physical medicine services, including PT and occupational therapy. More…

Medical Provider Dispute Resolution

Have a problem with a carrier? Use the IC’s Form 26I and initiate this new effective process.

Helpful Links

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