Virginia Workers' Compensation Commission
Virginia Workers' Compensation Commission
Electronic Medical Billing
[16 VAC 30 ‑ 16]

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 | Yes, changes to this chapter of the VA Administrative Code are exempt from Article 2 of the Administrative Process Act. |
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 333 E. Franklin Street Richmond, VA 23219 |
Email Address: | james.szablewicz@workcomp.virginia.gov |
Telephone: | (804)205-3097 FAX: (804)823-6936 TDD: ()- |
Current Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
None |
Past Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
Workers’ Compensation Electronic Medical Billing | Final | Stage complete. This regulation became effective on 02/06/2019. |