Delete Line to the Accident Medical Claim Form and eSign it in minutes

Aug 6th, 2022
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How to Delete Line to the Accident Medical Claim Form

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Getting back to work as soon as safely possible can be the best medicine for injured workers. When a worker is injured on the job in Washington State, they work with their medical provider to file a Report of Accident form or ROA which is submitted to the Washington State Department of Labor Industries. When an accident report is filled out by hand, then mailed or faxed to LI, there may be delays in providing services or benefits to your patient. LI receives an average of 90,000 pages by mail and fax every day. Thats a stack of paper 37 feet tall taller than a 3-story building! On top of that, incomplete forms, distorted faxes, damaged mail, and illegible handwriting can slow the process by several days or even weeks! This post-injury time is critical! Delayed treatment and missed work extend a workers recovery and take a toll on workers, their families, and their employers. But when the accident report is filled out online through FileFast, it speeds the claim by at least

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Below are some common questions from our customers that may provide you with the answer you're looking for. If you can't find an answer to your question, please don't hesitate to reach out to us.
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Call your insurance company with your name and claim number, and ask them to cancel your claim. Be prepared to explain why you want to cancel the petition, and ask if you need any documentation to finalize the cancellation. Please notice that your insurance provider is likely to report the incident.
Field by Field Explanation Of The CMS-1500 Form a. PATIENT NAME from Patient Master. Patient DOB and SEX from Patient Master. Name of the INSURED PERSON of the destination payer in Insurance Information screen under Patient Master. PATIENT ADDRESS, CITY, STATE, ZIP CODE HOME PHONE from Patient Master.
Complete box 22 (Resubmission Code) to include a 7 (the Replace billing code) to notify us of a corrected or replacement claim, or insert an 8 (the Void billing code) to let us know you are voiding a previously submitted claim. Enter the Blue Cross NC original claim number as the Original Ref.
Box 23 is used to show the payer assigned number authorizing the service(s).
A Place of Service (POS) is a field used when completing a CMS 1500 form to submit a claim to insurance. It indicates the location in which the health care service is actually provided.
Box 23 - TITLE: Prior Authorization Number (this field is also used for CLIA numbers) INSTRUCTIONS: Enter any of the following: prior authorization number, referral number, or Clinical Laboratory Improvement Amendments (CLIA) number, as assigned by the payer for the current service.
Make Changes, Add Reference/Resubmission Numbers, and Then Resubmit: To resolve a claim problem, typically you will edit the charges or the patient record, add the payer claim control number, and then resubmit or rebatch the claim.
Box 14 - Date of Current Illness, Injury, or Pregnancy (LMP) Enter the applicable qualifier to identify which date is being reported.

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