Workers Compensation Case

Cases allow specific information for repeated Charges and Appointments per patient.

Workers Compensation Policy

The Insurance Profile for Workers Comp should be added first. See Workers Compensation Policy Profile.

Add a Workers Compensation Case

On the Patient or Encounter Dashboard, select the Cases link. For adding a Case to an Appointment, see Add a Case to an Appointment.

1. Select the Add button.

2. Type: Choose Worker's Comp (WC) from the dropdown.
3. Enter a Description. This displays on the Charge and in Scheduling. This is the suggested format: Date of Injury (DOI), side, location. Example: 12/13/17 left ankle
4. Default & Active

• Default: Selecting the Default checkbox will default this Case to every new Encounter/Charge and Appointment.
• Active: Selecting the Active checkbox and leaving the Default checkbox blank allows the use of this case but does not automatically default to this Case and can be expired when no longer needed.

5. Insurance Profile: Choose the Workers Comp Policy Profile. If the Profile is not a choice, add the Profile. See Workers Compensation Policy Profile . Return to the Case to choose the WC Profile.
6. Case Number: Enter a Case Number if applicable.

7. Cause: Choose a Cause from the dropdown menu. (***This may not be required in your state.).
8. Date of Current: This is the date the Patient was treated at your office. (***This may not be required in your state.)

• When the Date of Current is entered and Illness (L) is chosen for Cause, an indicator of 431 is sent to indicate the Onset Date.
• When the Date of Current is entered and Injury (I) is chosen for the Cause, an indicator of 454 to indicate an Initial treatment (Chiropractic).

9. Accident: Required for Workers Comp. Changes to the accident fields will not be saved until the Add/Modify Charge screen is saved.

• Enter Accident Date.
• Choose Related Cause.
• Choose the second Related Cause if applicable.

• Example: Auto Accident that occurred on the job.

• Related Cause 1: Employment
• Related Cause 2: Auto Accident

• Select State.
• Select Save (F2).

10. The DX code can be keyed but is usually left blank when the charge originates from the Clinical Documentation.
11. Select Save (F2).

Add Authorization

1. Select Add Authorization.  See Add Authorization in Cases and Authorizations.

Other Fields

1. Select the Plus icon to the left of Other Fields.

2. Select the Employer (Informational Only; not used on Claim.)
3. Select the Body Side from the dropdown: Right, Left, Bilateral, None/Other.***
4. Select the Body Part from the Lookup icon.***
5. Enter the WC Claim ID in the Other Claim ID field (the unique character/number generated by Workers Compensation.) Y4 plus the WC Claim ID will be populated on the paper HCFA in Field 11b. You can also add this ID in the WC Claim ID, but that will not populate it on the claim.

6. Select Save (F2).

Add Contacts

See Case Contacts.

Condition Codes

If a condition code is needed on HCFA Box 10D:

• On the Encounter Dashboard, select the HCFA Fields link.
• Enter the Condition Code in Box 10.
• Select Save [F2].

Send a Workers Comp Appointment to a Worklist

See Add an Appointment to a Worklist.