Workers Compensation Claims Submitting Attachments

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Ophelia Miles
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1 Workers Compensation Claims Submitting Attachments STEP 1 SUBMIT THE CLAIM To submit attachments for Workers Comp claims, users must first submit the Workers Comp claim through Office Ally. The claim must contain the following information: Accident Date (Box 14) Authorization Number (Box 23) Once the user submits the Workers Compensation claim through Office Ally, they must then wait for the processing cycle to complete. The Claim Number will be needed to find the claim to link the attachment to. STEP 2 SUBMIT THE ATTACHMENT The user has two options to link and submit the attachment to Workers Compensation. Option 1: Utilizing the Attachment tool in the Office Ally Service Center Menu OR Option 2: Faxing the attachment to Workers Comp using the Attachments Cover Page. (located on the last page of this document) OPTION 1: ATTACHMENT TOOL VIA OFFICE ALLY Put your mouse over the Attachments tool Click Claim Search P age

for the processing cycle to complete. The Claim Number will be needed to find the claim to link the attachment to.

2 Claim Search By clicking the Claim Search feature you can search for claims submitted to the Workers Compensation payers through Office Ally. Select the Payer the claim was submitted to Select Date Type (Date of Service / Upload / Processed) Enter the From and To Date If you have any other information you d like to search by, you can enter that information as well in the search tool Once you ve entered your search criteria, click the Search button. The results will be returned below the search tool: Page

Select the Payer the claim was submitted to Select Date Type (Date of Service / Upload / Processed) Enter the From and To Date If you

3 Locate the claim you wish to send an Attachment for (verify claim number) and click the ATTACH link next to it (on the left). You will be taken to the Attachment screen for the claim selected: Click the Select File button A browser window to your PC will open Locate and click on the attachment you want to submit, click Open: Page

You will be taken to the Attachment screen for the claim selected: Click the Select File

The document will show in the Attachments box Select the Attachment Type from the drop down menu below Description Click Upload File to upload the attachment The program will ask you to confirm the

4 The document will show in the Attachments box Select the Attachment Type from the drop down menu below Description Click Upload File to upload the attachment The program will ask you to confirm the submission of the attachment. Click Yes. The attachment will display in the Existing Attachments section. You may Delete or Download (view) the attachment, if needed. the attachment OPTION 2: FAXING THE ATTACHMENT TO WORKERS COMP USING ATTACHMENT COVER PAGE If the user does not want to submit the attachment electronically they may: Complete the Attachments Cover Page form (next page). All fields on the form are required User may only submit attachments related to the specific claim. Place the attachment behind the cover page form Fax to the number provided on the Attachments Cover Page form Page

the attachment OPTION 2: FAXING THE ATTACHMENT TO WORKERS COMP USING ATTACHMENT COVER PAGE If the user does not want to submit the attachment electronically they may: Complete the Attachments Cover

5 Attachments Cover Page Provider Patient Office Ally Claim ID: Billing Provider: Patient Last Name: Patient First Name: Patient ID: **NOTE: This should be the Office Ally Claim ID which you can find in your File Summary and/or Inventory Reporting tool, this is not the same as the Claim No. from the Claim List (Claims/Billing tab) in Practice Mate. Patient Account Number: Bill Worker's Comp Claim Number: Total Charge Amount: Date of Service: Attachment Type AS Admission B2 Prescription B3 Physician B4 Referral Form CT Certification DA Dental Models DG Diagnostic Report Transmission Number of Pages: Fax Number: DS Discharge Summary EB Explanation of Benefits MT Models NN Nursing Needs OB Operative Note OZ Support Data for Bill Contact Name: Send Date: PN Physical Therapy Notes Prosthetics or Orthotic Cert. PZ Physical Therapy Cert. RB Radiology Films RR Radiology Reports RT Report of Tests and Analysis Comments: This cover sheet should only be used to submit attachments for bills that have been transmitted electronically to Office Ally. Please use ONE cover sheet per bill

Patient Account Number: Bill Worker's Comp Claim Number: Total Charge Amount: Date of Service: Attachment Type AS Admission B2 Prescription B3 Physician B4 Referral Form CT Certification DA Dental

Workers Compensation Claims Submitting Attachments

Workers Compensation Claims Submitting Attachments STEP 1 SUBMIT THE CLAIM To submit attachments for Workers Comp claims, users must first submit the Workers Comp claim through Office Ally. The claim must