The reality is that medical bills go unpaid often because of coding errors and lack of familiarity with the Official Medical Fee Schedule (OMFS). This seminar will highlight common problems with medical bills submitted to carriers and offer some best practices for reducing bill disputes and getting treaters paid.

This seminar is designed to assist medical billers, office managers, sole practitioners and medical-bill reviewers to prepare bills properly under the California workers' compensation fee schedule. Instructor Sue Honor is the Medical Unit Manager for the California Division of Workers' Compensation. She understands firsthand the minefield that medical billers face in submitting charges to carriers, TPAs and self-insured employers for prompt payment.

Course Objectives:

- How physicians bill when the CPT code isn't in the fee schedule
- How physicians cross-walk from the OMFS to the current CPT codes
- Surgery and Physical Medicine ground rules
- How to deal with pharmacy drugs dispensed from the office
- Compound drug and topical ointment calculations
- Current rules, formulas for inpatient / outpatient facilities
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies
- Pricing DMEPOES items not in the Medicare fee schedule
- Clinical laboratory fees: which schedule to use for various services
- Ambulance service
- Medical-legal bills
- How to price when there isn't a fee schedule
- Exempt providers and exempt services

Who Should Enroll:
Claims Managers, Claims Assistants, TPA's, Self-Insurers, and Nurse Case Manager and Claims adjusters, too, can benefit from this six-hour overview of the California OMFS.