Employers

Electronic billing “e-billing” is the electronic exchange of medical bills and documentation between providers and payers in the workers’ compensation system according to a defined set of uniform guidelines. In Virginia, § 65.2-605.1 Subsection G of the code of Virginia and Virginia Workers’ Compensation Commission Rule 16VAC30-16 established standards and methods for the electronic exchange of medical billing and payment remittance for medical services and products provided to injured workers on or after July 1, 2019.

Electronic billing “e-billing” is the electronic exchange of medical bills and documentation between providers and payers in the workers’ compensation system according to a defined set of uniform guidelines. In Virginia, § 65.2-605.1 Subsection G of the code of Virginia and Virginia Workers’ Compensation Commission Rule 16VAC30-16 established standards and methods for the electronic exchange of medical billing and payment remittance for medical services and products provided to injured workers on or after July 1, 2019.

 The medical community regions map displays the location within the community for providers of medical services. The zip code for the location where medical services are rendered determines the medical community region.

 The Medical Fee Dispute Resolution Process provides instructions for providers and payers when there is a dispute for medical dates of service prior to 01/01/2018.

 The Medical Fee Schedule Update Notice provides instruction and notification for amendments made to the schedules.

The ADR Brochure provides a useful overview of the four basic dispute resolution services offered by the Commission’s ADR Department -- Full and Final Mediation, Issue Mediation, Issue Facilitation, and Orientation Sessions -- as well as contact information for more learning.

 This is an example of a Variance Notification. Upon receipt, Claim Administrators should check the file payment history against the award history. If there are any payment discrepancies, submission of an EDI transaction will be required to reconcile.

 The Medical Fee Dispute Resolution Process provides instructions for providers and payers when there is a dispute for medical dates of service prior to 01/01/2018.

Click here to provide comments on the Medical Fee Schedule Dispute Resolution Process.