Main Guide

Workers Comp Process

Active

Purpose

To help staff correctly verify, register, and process patients who present for a workers comp visit. This guide explains what information is needed, when to register the patient as workers comp, when to use the workers comp self-pay mnemonic, and how to request a drug screening when required.

Situation / Scenario

Use this guide when a patient presents for treatment and states the visit is related to workers comp or a work injury. Staff must verify whether the visit can be registered as workers comp by checking for paperwork from the employer or by confirming the information with a supervisor or employer contact.

Step-by-Step Instructions

  • Ask the patient if they have paperwork from their employer stating this is a workers' comp visit.
  • Review the paperwork to confirm the workers' comp information.

Helpful Tips

  • Always verify workers comp before registering the patient as workers comp.
  • Employer paperwork is the easiest way to confirm the visit.
  • If paperwork is missing, try to speak with the patient’s supervisor.
  • If the supervisor is not present, the patient may call the supervisor so staff can obtain the information.
  • Always ask whether a drug screening is needed. - If a drug screening is needed, confirm whether it is DOT or non-DOT.
  • Use WCSELF when the patient claims workers comp but does not have the needed workers comp information.
  • The patient has 5 days to provide workers comp information before the bill is billed out.
  • For drug screenings, the employer protocol should be checked in the Loop first.
  • If the protocol is not in the Loop, use the attached form and complete it with the supervisor or employer’s HR department.

Common Mistakes

  • Registering the patient as workers comp without paperwork or supervisor verification.
  • Not asking whether a drug screening is needed.
  • Not confirming whether the drug screening should be DOT or non-DOT.
  • Forgetting to collect the supervisor’s name.
  • Forgetting to obtain who the bill should go to.
  • Forgetting to obtain the billing address, phone number, or claim number when available.
  • Not using WCSELF when the patient claims workers comp but has no workers comp information.
  • Forgetting to fax the drug screening form to the lab.
  • Using the wrong employer protocol.
  • Not escalating when the information cannot be verified.

What NOT To Do

  • Do not register the patient as workers comp without proper paperwork or verbal confirmation from a supervisor/employer contact.
  • Do not assume the visit is workers comp just because the patient says it happened at work.
  • Do not skip the supervisor verification step when paperwork is missing.
  • Do not forget to ask about drug screening requirements.
  • Do not send the lab an incomplete drug screening form.
  • Do not leave the patient without instructions if workers comp information is missing.
  • Do not enter patient-specific identifiers into the help bot or guide request form.