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Billing Guide

This Billing Guide outlines the workers’ compensation billing requirements for Alaska.

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 Alaska.

Forms

Services

DaisyBill Resources

CMS-1500*

Physician Services

Pathology / Laboratory

DME

CMS-1500 Instructions

UB-04

Facility

No Form Specified

Pharmacy

No Form Specified

Dental

*Recommended, but not required

State-Mandated Physician Reporting Requirements

For a complete bill, Alaska requires providers to submit supporting documentation with a bill for services. The following table lists the types of attachments that may accompany a bill to fulfill this supporting documentation requirements.

Attachment Description

Number of Days until Due after Date of Service

 Form Link

Physician’s Report

14 calendar days

Form 07-6102 (Rev 01/2013) Physician's Report 

A Written Treatment Plan

14 calendar days from start of treatment

No Specific Form

Electronic Billing Mandate

The Alaska Division of Workers’ Compensation 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.

Important Resources

2019 Alaska DWC Official Medical Fee Schedule

The Alaska OMFS provides guidelines and the methodology for calculating rates for services.

Section 23.30.097 Fees for Medical Treatment and Services

This section of the 2018 Alaska Statutes outlines the regulations for medical treatment.

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