Required Medical Bill Treatment and Diagnosis Information

Medical providers receive expeditious processing of medical bills by submitting their bills with the following information:

• Description of accident or occupational disease; 
• Detailed description of injury;
• Is the injury causally-related?
• Details of prior injuries, diseases or physical impairment, including prescription drug history;
• Date of your first treatment;
• Current diagnosis, prognosis and anticipated treatment plan; advise if treatment is continuing, and include the next scheduled treatment date;
• Include ICD 9 (International Classification of Diseases, 9th Revision) code for each diagnosis;
• Provide results of diagnostic tests rendered;
• For medical authorization requests, provide medical necessity for any treatment, diagnostic test(s) or surgery;
• Provide first day (“date”) injured worker was unable to perform work due to his/her impairment;
• Provide injured worker's current work status;
• Advise if patient is able to perform regular duties; If no, tell us why;
• Include any work restrictions as well as the degree of disability: total, marked, moderate or mild;
• Advise if patient can perform any type of work; If yes, describe work capacity.