This Billing Guide outlines New Hampshire’s workers' compensation billing requirements and DaisyBill’s resources on how to file 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 New Hampshire.
Forms |
Services |
DaisyBill Resources |
CMS-1500* |
Physician Services |
|
UB-04 |
Facility |
|
Not Specified |
Pharmacy |
|
Not Specified |
Dental |
State-Mandated Physician 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 New Hampshire.
Attachment Description |
Number of Days until Due |
Form Link |
Workers’ Comp Medical Form |
10 days |
Electronic Billing Mandate
The New Hampshire Workers' Compensation Division 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
Stay up-to-date on the latest developments in Workers’ Compensation medical billing by subscribing to DaisyBill’s email list.