Pursuant to Title 8CCR §9793(l&n), when submitting a bill, providers should always include:
- Correspondence – Cover Letter / Advocacy Letter
- Declaration & Attestation of Total Page Count (which is often at the end of the cover letter)
In the rare instance where there is no advocacy letter, providers can supply the “Request for the QME.” Sometimes that might just be an email or fax.
When billing for no-shows, billers should include the request to cancel the appointment. Even if that request was made via email, providers can still attach it as a supporting document to their no-show bill. Having the correspondence from the parties supports the bill for the no-show.
If a party calls to cancel an appointment or reschedule, ALWAYS get it in writing, because a call does not offer tangible proof of a request. The request to cancel or reschedule a QME can be used in place of a report when submitting your bill.
If an injured worker or interpreter fails to show for a QME, the Simplexam program generates a letter that can be used as supporting evidence when submitting your bill. Simplexam document workflow ensures required documents for billing are available to be included with the final report.
