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South Carolina Workers� Comp News: Part II

January 11th, 2007 Posted by Mark

The South Carolina Workers’ Compensation Commission is not stopping with just a new mediator for appealed workers’ comp claims. It has also set up a new hospital payment system that went into effect last year and is now in full effect. The new system could come as a shock to employers who self insure for their workers’ comp coverage, or even their insurance companies if an employer goes through an insurance company for the coverage.

Anticipating that trouble, the South Carolina Workers’ Comp Commission has offered to help out any self insured employers, insurers, or any one else handling workers’ comp bill payments to make the transition to the new hospital billing and payment system. As such, I’ve got wind that the Commission is offering to price, for free, any hospital outpatient, inpatient, or ambulatory surgery bill. To get this service, send these bills to the South Carolina Workers’ Comp Commission’s Medical Services Division, which will then reprice the bills according to the new system. The new rate is Medicare’s current pricing rate, plus an additional 40 percent.

If you or the medical provider sending these bills to you have any sort of problem with the new rate or a particular workers’ comp medical bill, the Medical Services Division also offers to mediate any sort of dispute. You can request the Medical Services Division to do an administrative review of the bill.

This whole system change has come about in South Carolina because the commission is getting a bit fearful of the enormous raise in the costs of medical care when it comes to workers’ comp. The system overall is meant to save employers as much as $60 million a year on workers’ comp medical bills. That alone should make you and other South Carolina employers very enthusiastic about the new hospital bill system and pricing.