The Tennessee Bureau of Workers’ Compensation has issued rules changing the provisions of the Medical Fee Schedule, Chapters 0800-02-17, -18, -19, which are effective February 25, 2018. Hospitals, Insurance Carriers, and Bill Reviewers need to be prepared to price and adjudicate bills for workers’ compensation according to the new regulations for all claims on or after February 25, regardless of the date of injury.
EnableComp, along with the Tennessee Hospital Association and several other industry leaders were tasked by the Tennessee Bureau of Workers’ Compensation to come up with a way to make the hospital Fee Schedule more efficient and less burdensome on all parties. The resulting rule-changes establish a whole new set of rates and payment thresholds, all designed to be revenue neutral across the Tennessee work comp system.
Major Changes to how Hospitals are paid include:
- Increases in Per Diem Rates and Stop-Loss Thresholds
- Changes in how Trauma is defined
- Elimination of Inpatient Carve-Outs in the Stop Loss calculation
- No additional Implant reimbursement for Outpatient claims
EnableComp was thrilled to be part of the task force that featured Provider and Payer advocates working side-by-side to make the work comp system better for everyone as well as receiving a letter of gratitude from Administrator Abbie Hudgens recognizing our effort.
Current hospital clients of EnableComp will not need to take any action pursuant to these rule changes as our system handles these issues seamlessly.
Other hospitals interested in learning more about EnableComp or how these new Fee Schedule rules will affect their business should contact us at firstname.lastname@example.org or (615) 791-4300.
2018 Tennessee Workers’ Comp e-Billing Webinar
One of our major focuses at EnableComp is to monitor and report on legislative and industrial changes that have material impact to our business. As a national work comp revenue cycle company with over 600 hospital clients across the country, you can imagine that we (and the rest of the work comp community) have been watching Tennessee for quite some time as the changes within work comp have been significant over the past few years. Now with the State moving toward requiring work comp billing to be all-electronic in 2018, we review the proposed mandate for Work Comp e-Billing.
This webinar addresses:
- Approved e-Billing Formats
- Payer and Provider Deadlines and Exemptions
- Potential Solutions and Next Steps