The CMS-1500 (HCFA) Form is used by healthcare providers and professionals to file original workers' compensation medical bills in Nebraska.
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 Nebraska.
Forms |
Services |
DaisyBill Resources |
CMS-1500 |
Physician Services |
|
UB-04 |
Facility |
|
Not Specified |
Pharmacy |
|
Not Specified |
Dental |
State-Mandated Physician Reporting Requirement
This table is a guide to DaisyBill's resources on the reporting forms required for compliant paper and electronic workers’ comp billing in Nebraska.
Report |
Form |
Requirement |
Report “specifically setting forth the nature and extent of the injury or disease” |
CMS-1500 |
Furnished to the employer within 14 days following the first treatment |
Electronic Billing Mandate
The Nebraska Workers' Compensation Court 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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