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Virginia Workers' Compensation Commission
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Virginia Workers' Compensation Commission


chapter
Workers’ Compensation Electronic Medical Billing [16 VAC 30 ‑ 16]
Guidance Documents   Periodic Reviews
Chapter Information
Description The intent of the proposed regulation is to adopt and implement infrastructure under which (i) providers of workers’ compensation medical services (“providers”) shall submit their billing, claims, case management, health records and all supporting documentation electronically to employers or employers’ workers’ compensation insurance carriers (“payers”) and (ii) payers shall return actual payment, claim status , and remittance information electronically to providers that submit their billing and required supporting documentation electronically. The proposed regulation will establish standards and methods for such electronic submissions and transactions that are consistent with the electronic medical billing and payment guidelines of the International Association of Industrial Accident Boards and Commissions.
State Authority Subsection H of Section 65.2-605.1 of the Code of Virginia; Chapter 621 of the 2015 Acts of Assembly .
Federal Authority N/A
Exempt from APA No, changes to this chapter are subject to the Administrative Process Act and the standard executive branch review process.
Text of Regulation Link to Virginia Administrative Code
Goals of Regulation Promulgated pursuant to the direction of the Virginia General Assembly in Chapter 621 of the 2015 Acts of Assembly, the purpose of the regulation is to provide a legal framework for electronic billing, processing, and payment of medical services and products provided to an injured worker subject to the Virginia Workers’ Compensation Act. The proposed regulation will expedite the submission, processing and payment of bills for medical services rendered to injured workers pursuant to the Virginia Workers’ Compensation Act utilizing nationally recognized standards.
Meetings

Contact Information
Name / Title: James J. Szablewicz  / Chief Deputy Commissioner
Address: Virginia Workers' Compensation Commission
1000 DMV Drive
Richmond, VA 23220
Email Address: james.szablewicz@workcomp.virginia.gov
Telephone: (804)367-8664    FAX: (877)432-5423    TDD: ()-
Current Actions
Action Title Latest Stage Status
Workers’ Compensation Electronic Medical Billing NOIRA Stage complete. Comment period ended 7/13/2016.

Past Actions
Action Title Latest Stage Status
None