Personal Injury & Workers' Compensation Services in New York
When accidents occur, the last thing you want to worry about is billing. Let TMS Billings handle your personal injury billing services, ensuring all NF-3 forms, PIP claims, and AAA arbitration are processed accurately and efficiently.
Making Personal Injury Payments Simple with NF-3
Treatment Verification
Treatments, such as doctor visits and physical therapy, are confirmed as necessary for accident-related injuries.
Patient & Policyholder Info
Accurate details, including injury diagnosis, treatment dates, and charges, are ensured to prevent delays.
Provider Info & AOB
Healthcare provider details are verified, and an Assignment of Benefits (AOB) is included for direct provider payment.
Accurate Billing
New York's fee schedules are followed to guarantee proper reimbursement, avoiding issues with no-fault claims medical billing.
Efficient Filing
The NF-3 form is filed promptly to ensure timely payments.
Expert Handling of the 45-Day Deadline
Managing the 45-day rule requires more than just standard billing workflows. The 45-day rule in New York requires medical providers to submit claims for personal injury and workers’ compensation within 45 days of treatment or the date of service.
At TMS Billings, we navigate this rule with expertise:
No-Fault Claims
TMS Billings ensures all medical bills for personal injury medical billing under No-Fault insurance are submitted within 45 days of treatment, guaranteeing swift processing. By staying on top of deadlines, we prevent claim denials and delays in payment for personal injury medical bills.
Workers' Compensation
The 45-day clock starts when the injury or illness occurs or when medical attention is first sought. With our deep expertise, claims are filed within this window, ensuring reimbursement eligibility is met without complications.
Timely Submission
TMS Billings manages the entire no-fault claims medical billing process, ensuring that all documentation is submitted within the critical 45-day window.
Your Partner in Personal Injury and Workers’ Compensation Claims
Complete billing solutions for No-Fault and Workers’ Compensation claims, from NF-3 filings to C-4 forms, WCB fee schedules, and the 45-day rule, ensuring smooth, compliant claim processing.
Managing PIP Claims and Arbitration Efficiently
TMS Billings specializes in managing and resolving disputes through AAA arbitration. We ensure coordination with PIP carriers and handle any arbitration needs.
In New York, personal injury protection (PIP) provides no-fault coverage for medical bills and lost wages after an auto accident. TMS Billings ensures that PIP claims are filed accurately, covering 80% of medical expenses and up to 60% of lost wages.
If PIP claims are denied or delayed, TMS Billings takes care of the arbitration process through the American Arbitration Association (AAA):
Filing a Request: We manage the arbitration request, submitting all necessary documentation.
Conciliation & Arbitration: We handle conciliation efforts and, if needed, proceed to arbitration for a fair resolution.
Decision & Award: We ensure timely arbitration decisions, speeding up reimbursement.
Delays in PIP claims can disrupt cash flow and patient care. Our expertise in PIP and AAA arbitration means your practice avoids costly delays and stays on track with payments.
Managing C-4 Filings for Workers' Compensation Claims
The right start makes all the difference when it comes to workers’ compensation and C-4 filings. At TMS Billings, we ensure your workers’ compensation claims are filed accurately and on time.
What’s Included in a C-4 Filing
- Accident Description: A thorough, detailed description of how and when the injury occurred is crucial. We make sure this is done clearly and correctly.
- Injury Details: We identify and document all body parts affected by the injury, ensuring nothing is overlooked.
- Witness Information: If there were any witnesses to the injury, we ensure their details are properly included, supporting the validity of the claim.
- Physician’s Information: The physician’s role in documenting the initial treatment is key. We ensure the bottom section is filled out accurately and submitted directly to the employer and insurance carrier.
- Filing Deadlines: We keep track of the 90-day filing window, ensuring the C-4 form is submitted on time to prevent unnecessary delays.
- Record Keeping: We ensure that a copy of the C-4 form is retained for future reference, safeguarding your practice’s documentation.
Navigating WCB Fee Schedule
Getting paid for workers’ compensation starts with understanding the WCB fee schedule. It sets the standard for reimbursement, and it is key to smooth, timely payments. And at TMS Billings, we know the ins and outs of the WCB fee schedule.
Key Aspects of the WCB Fee Schedule
The WCB fee schedule sets standard payment amounts for medical services in workers’ compensation claims. We manage:
- Service Codes and Values: Each CPT code is linked to a specific payment amount, and we ensure they are applied correctly.
- Modifiers and Packaging: We handle the application of global packages and modifiers to adjust reimbursement accurately.
- Pharmacy and Ancillary Fees: We ensure proper handling of pharmacy and ancillary service charges as per the WCB schedule.
By managing these details, we make sure your workers’ compensation medical bills are fully compliant, and reimbursement is maximized.
FAQs
Frequently Asked Questions
Do you have questions about our medical billing and coding company? Let’s help you out.
Do you only work with New York practices?
New York is the core focus. We also support surrounding states when a group has locations that cross state lines, for example New Jersey and Connecticut. The approach stays the same. Regional payor rules, portals, and workflows, not generic billing.
Do you handle New York Medicaid, both fee for service and managed care?
Yes. We handle New York Medicaid fee for service workflows tied to eMedNY, plus Medicaid managed care plan billing. That includes eligibility checks, claim status follow up, denials, resubmissions, and appeals.
What is eMedNY, and why does it matter?
eMedNY is New York’s Medicaid system for provider billing operations, reference material, and tools like claim status inquiry. If a billing team does not know how to work eMedNY correctly, you usually see it in slow claim fixes and aging A R.
We already have a workflow. What changes when we switch?
We merge into your existing workflow. If you want, we take specific steps off your staff’s plate while you keep control of the rest. If you want a full transition, we take the workflow over from the prior billers and keep it moving with minimal disruption.
Will you work inside our current EMR, PM, and clearinghouse?
Yes. Most practices want continuity. We work in your existing system and document the workflow so your team knows what is happening and where to look.
If you do not have a platform, or your current platform is controlled by a billing vendor and you cannot keep it, TMS can provide a platform so you are not boxed in.
If your practice prefers paper and superbills, we can run the workflow that way too.
