PROCEDURE 17-1Verifying Workers Compensation Coverage

Goal: To verify workers compensation coverage before accepting a patient OSHA Guidelines. This procedure does not involve exposure to blood, body fluids, or tissue.MaterialsTelephone, paper, and a pen

1. Call the patients employer and verify that the accident or illness occurred on the employers premises or at an employment-related work site.

2. Obtain the employers approval to provide treatment. Be sure to write down the name and title of the person giving approval, as well as his phone number.

3. Ask the employer for the name of its workers compensation insurance company. (Employers are required by law to carry such insurance. It is a good policy to notify your state labor department about any employer you encounter that does not have workers compensation insurance, although you are not required to do so.)If the employer has not done so, remind them to report the incident to the W/C carrier, using the First Report of Injury or Illness, and to the state labor department within 24 hours of the incident.

4. Contact the insurance company and verify that the employer does indeed have an active policy in good standing with the company.

5. Obtain the claim number assigned to the case from the insurance company. This claim number is placed on all claims and submitted paperwork.

6. When the patient begins treatment, create a patient record. If the patient is already an active patient with the practice, create separate medical and financial records for the workers compensation-related treatment.