This Billing Guide outlines Maine’s workers' compensation billing requirements and daisyBill’s resources on how to file compliant medical bills.
Billing Form Requirements
This index is a guide to daisyBill's resources on the required forms for compliant paper and electronic workers’ comp billing in Maine.
Forms |
Services |
daisyBill Resources |
CMS-1500 |
Physician Services Laboratory / Pathology Facility – Outpatient DME Dispensed Pharmaceuticals |
|
UB-04 |
Facility – Inpatient |
|
Not Specified |
Pharmacy |
|
Not Specified |
Dental |
State-Mandated Physician Reporting Requirements
For a Complete Bill, Maine 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.
Service |
Attachment Description |
Number of Days until Due |
Form (PDF) |
Initial Evaluation |
Medical Report |
5 days from evaluation |
|
Interim Evaluation |
Medical Report |
Every 30 days |
|
Final |
Medical Report |
5 days from evaluation |
|
Upon Request |
Medical Report |
10 days from request |
Electronic Billing Mandate
The Maine Workers’ Compensation Board does not regulate electronic billing for medical bills. Accordingly, contact the payer to determine if workers’ comp bills can be submitted electronically.
daisyBill Solution
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