{"id":6391,"date":"2022-04-18T14:21:49","date_gmt":"2022-04-18T19:21:49","guid":{"rendered":"https:\/\/pmaworks.com\/observations\/?p=6391"},"modified":"2022-04-18T14:24:16","modified_gmt":"2022-04-18T19:24:16","slug":"insurance-key-references","status":"publish","type":"post","link":"https:\/\/pmaworks.com\/observations\/insurance-key-references\/","title":{"rendered":"Insurance Key References"},"content":{"rendered":"
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Following is a list of links to various publications with helpful information on insurance filing guidelines and requirements.\u00a0 At the bottom is a convenient downloadable document with all of this information listed.
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Wisconsin Worker\u2019s Compensation Treatment Guidelines DWD CH 81.04
\nhttps:\/\/docs.legis.wisconsin.gov\/code\/admin_code\/dwd\/080_081\/81<\/a><\/p>\n

General.<\/em>\u00a0Except as set forth in\u00a0par.\u00a0(b)<\/a>\u00a0and\u00a0s.\u00a0DWD 81.04 (5)<\/a>, a health care provider may not direct the use of passive treatment modalities in a clinical setting as set forth in\u00a0pars.\u00a0(c)<\/a>\u00a0to\u00a0(i)<\/a>\u00a0beyond 12 calendar weeks after any of the passive modalities in\u00a0pars.\u00a0(c)<\/a>\u00a0to\u00a0(i)<\/a>\u00a0are initiated. There are no limitations on the use of passive treatment modalities by the patient at home. DWD 81.06(3)(a)<\/p>\n

Wisconsin Worker\u2019s Compensation Tx Guidelines Departure from Guidelines \/ Exceptions
\nDWD 81.04(5)<\/a> (5)<\/strong>\u2002Departure from guidelines.\u00a0A health care provider’s departure from a guideline that limits the duration or type of treatment in this chapter may be appropriate in any of the following circumstances:
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Wisconsin Unfair Claims Settlement Practices
\nIns 6.11\u2003\u00a0Insurance claim settlement practices.https:\/\/docs.legis.wisconsin.gov\/code\/admin_code\/ins\/6\/11\/3<\/a><\/p>\n

Wisconsin Medicaid CMS1500 Claim Instructions
\nhttps:\/\/www.dhs.wisconsin.gov\/forms\/f0\/f01234a.pdf<\/a>
\nhttps:\/\/www.forwardhealth.wi.gov\/kw\/pdf\/2008-89.pdf<\/a><\/p>\n

Wisconsin Medicaid \u2013 New Requirements and Clarification of Chiropractic Services
\nhttps:\/\/www.forwardhealth.wi.gov\/kw\/pdf\/2016-35.pdf<\/a><\/p>\n

Documentation, SOI, 20 visit limit, exam clarification.
\nState of Wisconsin Insurance Equality
\n632.87(3)<\/a> Wisconsin Insurance Equality Chiropractic<\/a><\/p>\n

Medicare Supplement Mandated Benefits Wisconsin
\nhttps:\/\/oci.wi.gov\/Documents\/Consumers\/PI-002.pdf<\/a>
\nMedicare Supplement and Medicare SELECT policies cover the usual and customary expense for services provided by a chiropractor under the scope of the chiropractor\u2019s license. This benefit is available even if Medicare does not cover the claim. The care must also meet the insurance company\u2019s standards as medically necessary.<\/p>\n

Wisconsin Provider Manual Anthem BCBS
\nhttps:\/\/www.anthem.com\/docs\/public\/inline\/PM_WI_00006.pdf<\/a><\/p>\n

Wisconsin Anthem BCBS Commercial Reimbursement Policy
\nhttps:\/\/www.anthem.com\/docs\/public\/inline\/C-08010.pdf<\/a><\/p>\n

Wisconsin Anthem BCBS Commercial Modifier Rules
\nhttps:\/\/www.anthem.com\/docs\/public\/inline\/Modifier_Rules_2021.pdf<\/a><\/p>\n<\/div>\n

Downloadable Reference Guide: Insurance Key References<\/a><\/div>\n
<\/div>\n","protected":false},"excerpt":{"rendered":"

Following is a list of links to various publications with helpful information on insurance filing guidelines and requirements.\u00a0 At the bottom is a convenient downloadable document with all of this information listed. ~~ Wisconsin Worker\u2019s Compensation Treatment Guidelines DWD CH … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[559,16,7],"tags":[286,451,447,23,568,66,377,367],"class_list":["post-6391","post","type-post","status-publish","format-standard","hentry","category-medicare","category-reimbursement","category-chiropractic-reimbursement-insurance","tag-anthem","tag-driven","tag-goal","tag-insurance","tag-medicaid","tag-medicare","tag-michel","tag-petty"],"_links":{"self":[{"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/posts\/6391","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/comments?post=6391"}],"version-history":[{"count":5,"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/posts\/6391\/revisions"}],"predecessor-version":[{"id":6398,"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/posts\/6391\/revisions\/6398"}],"wp:attachment":[{"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/media?parent=6391"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/categories?post=6391"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pmaworks.com\/observations\/wp-json\/wp\/v2\/tags?post=6391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}