Doctor Management Services

What is the primary reason that QME claims never make it to the system? Accurate Coding of the QME report is critical because the billing is dependent on the type of the evaluation (comprehensive, follow-up, or supplemental), and codes only a few letters or numbers different from the codes coded on the report could lead to a claim denial. They are not routine visits, so simplifying the coding is not going to be a concern. The California workers’ comp system has special rules for QME medical billing and coding, and medical billers and coders must understand them, as well as how to write a report that accurately reflects the event to which it applies, rather than assigning a standard visit code.