Medical Office Assistants FAQs
Who should I call if I have questions about WorkSafeBC outstanding payments?
Call Payment Services at 604 276-3085 or toll free at 1 888 422-2228.
How do I get information about HIBC Teleplan billing?
Call HIBC at 604 456-6950 or toll free at 1 866 456-6950.
How long do we wait to re-bill when a claim is pending?
Currently there is not a specific time period, but you can periodically check your claim status online.
If a worker has a preexisting injury and a WorkSafeBC claim open in another province, and then comes to B.C. to work for a B.C. employer and reinjures the same area, how would a GP bill for the service?
The physician should fill out a Form 8. The physician should also ensure the worker phones Teleclaim or fills out a Form 6. A new claim should be started in B.C.
A Form 8 must be submitted within three business days; when does day one start?
The day of the medical visit is day zero. The report must be received by WorkSafeBC by the third business day after the visit. Payment will be reduced if the report is received 4 to 6 business days after the visit.
What happens if a worker is injured at work but does not want the doctor to send in a Form 8?
If the visit meets the criteria for Form 8, the doctor is obligated by law to send in the form. The doctor should encourage the worker to fill out a Form 6 or phone Teleclaim. Let the worker know that they can choose not to file a claim after Form 6 has been processed.
Filing a Form 6 protects the worker by documenting the visit, and if the worker changes their mind about filing a claim it will be easier to file later. The physician will not be paid for services if the worker does not file a claim.
How long is the typical wait time when phoning Teleclaim?
There are many Teleclaim operators, and the worker should not have to wait for the call to be answered. Once they are speaking with the Teleclaim operator it will take approximately 15 minutes to complete Form 6.
How detailed should the return-to- work consult (fee code 19950) be? Can we bill for a second one?
A return-to-work plan is developed through a consultation with a WorkSafeBC officer, employer, and worker. The plan should specify work hours, activities, progression of activity, and should also include the expected date of full return to work.
If after one consultation the worker is not successful in returning to modified, gradual, or transitional work one further consultation cycle may be approved by a WorkSafeBC officer. This second consultation will be invoiced as Fee Code 19950.
Can a Form 8 and a return- to-work form be billed on the same day?
No. The RTW plan is submitted on Form 8/11 and an additional Form 8/11 cannot be billed on the same day. The fee for RTW consultation is all-inclusive of form fee, visit, and consultation with others.
What software should we use for medical billing?
Information on WorkSafeBC’s IT requirements for medical billing software is available online at WorkSafeBC.com
What should I do if I run out of space to write on the Form 8/11?
Please continue filling out the form using a Practitioners report/additional information.
What is my Data Centre Code #?
Your Data Centre Code # will begin with a T followed by 4 digits, and is used for electronic billing.
What is a Form 6A?
This is a worker's report of injury or occupational disease to the employer.
How do we bill if the worker is transient with no PHN? Can we bill the worker the same date of service?
You must bill WorkSafeBC by paper (fax). Please use the Physician's Invoice. If you charge the worker, and it is determined to be an allowed claim, you must reimburse the worker and bill WorkSafeBC.
If the claim is rejected and under appeal can you bill for forms?
No. Nothing is payable in this case.
Can we bill through Teleplan if the worker has a PHN but it’s not currently active?
Yes, you can bill through Teleplan, as long as the worker has a PHN. It does not have to be active.
How do we bill if the worker is self-employed and does not have WorkSafeBC coverage (Personal Optional Protection)?
You can bill the worker or HIBC (MSP) if s/he has a PHN.
What items must be billed manually by faxing paper invoices?
You must bill manually (using paper/fax) if:
- the fee codes have seven digits
- the worker does not have a PHN
- The worker is from out-of-province or out-of-country
Also if you are billing for expedited sessional services, use the fee codes below on the WorkSafeBC surgery invoice and fax to 604 244-6292:
- Surgical Assist, fee code 19515
- Extensive Spine Surgery, 19516
- Extensive Spine Surgery Assist, 19517
- Extensive Spine Anesthesiology, 19518
- Anesthesiology Blocks - PSA , 19519
Does WorkSafeBC still pay if the Form 8/11 is not legible?
No. Please ensure the content is legible.
How do we get a claim number?
Phone the Call Centre at 604 231-8888 or toll-free at 1 888 967-5377.
What information can a provider get online regarding a claim?
The provider can see if the claim is active or inactive, the date of injury (effective date), whether the claim is allowed, disallowed, pending or rejected, the area of body, the side of body, the diagnostic code, and what health care entitlements are in progress.
Check your claim online.
When more than one body part was treated during surgery and both/all are accepted on the claim, can the surgeon bill for more than one MSP fee code?
Only one MSP fee code can be billed regardless of the number of areas treated.
When the worker does not show up for their expedited consultation appointment (and they have not cancelled) is there a code to bill? Can the cancellation code be billed?
Fee code #19936 may be billed for any Expedited Comprehensive Consultation when less than 24 hours’ notice of cancellation or a “no show” occurs.
Can you bill two separate days when a surgery has gone in to the next day (e.g., surgery starts at 10:00 p.m. and ends the next day at 7:00 a.m.)?
When a surgery lasts greater than 6 hours and starts late in the evening then finishes the next morning, use only one date of service to invoice — either the day the surgery started or the day the surgery finishes — whichever has the bulk of the time. (In other words, if the surgery started at 10:00 p.m. on the 19th and finished at 7:00 a.m. on the 20th you should use the 20th as the date of service.) Also, use fee code 19506 (6 hours plus) and bill two expedited surgery codes. If any extraordinary circumstances occur, contact WorkSafeBC Payment Service to investigate further.
When a patient has no PHN and the provider must invoice on paper, how can the provider track the payment from their MSP remittance (i.e., WorkSafeBC has billed on behalf of the provider)?
In the absence of a PHN# the provider has to invoice on paper, and WorkSafeBC uses the PIPS (Paper Invoice Processing System) to data feed using Data Centre Code W0001 and a pseudo PHN to process this invoice electronically on behalf of that provider.
Finding payment:
On the MSP Remittance Statement, next to amount paid. the Exp Code will be “W$”.
- This indicates “WorkSafeBC Claim Submitted to WorkSafeBC on Paper”. Invoice was processed by WorkSafeBC on PIPS software and paid by MSP.
The Data Centre Code will be W0001 instead of your usual code.
(If you are unable to view Code W0001 please contact your software provider for assistance. Your provider may have to enhance your software program in order to view transactions under this code.)