This Billing Guide outlines Utah’s workers' compensation billing requirements and daisyBill’s resources for filing compliant medical bills.
Billing Form Requirements
This table is a guide to daisyBill's resources on the required forms for compliant paper and electronic workers’ comp billing in Utah.
Forms |
Services |
daisyBill Resources |
CMS-1500 (HCFA) |
Physician Services Durable Medical Equipment Dispensed Pharmaceuticals |
CMS-1500 Instructions |
UB-04 |
Facility |
|
NCPDP |
Pharmacy |
|
ADA |
Dental |
|
Proprietary: [Form] |
[Services] |
[Form] Instructions |
Reporting Requirements
This table is a guide to daisyBill's resources on the reporting forms required for compliant paper and electronic workers’ comp billing in Utah.
Service |
Attachment Description |
Days until Due |
Form (PDF) |
Initial Report |
Physician's Initial Report of Injury |
7 days |
|
When the employee is leaving the state |
Attending Physician's Statement |
When requested by employee |
Electronic Billing Mandate
The Utah Labor Commission has not issued electronic billing regulations or rules for medical bills. Accordingly, contact the payer to determine if workers’ comp bills can be submitted electronically.
daisyBill Solution
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