Workers' compensation information system (WCIS)

Bill and claim counts by date of injury

The WCIS uses the Jurisdiction Claim Number (JCN), Insurer Federal Employer  Identification Number FEIN and Claims Administrator Claim number to match medical bills with FROI/SROI claims. Data presented in these tables are for claims matched with a FROI/SROI claim. It does not include unmatched data.

Table 2.1 shows the count of insurers reporting bills by date of injury. The WCIS collects Insurer FEIN data on each reported bill. This table is unique count of the insurer FEIN data.

Table number Table name
Table 2.1: Number Of Insurers Reporting Medical Data By Date Of Injury

Source: WCIS Medical Bill Payment Database as of June 2020

Table 2.2 shows the count of claims by date of injury and bill type. Claims reported on bills in HCFA/CMS 1500 are professional bills, those reported in UB92/04 are institutional bills, those reported in ADA Dental Claim Forms are dental bills, those reported in NCDP Workers' Compensation/Property & Casualty Universal Claim Form are prescription bills while claims on disputed bills with lump sum payments or settlements are reported as lien bills. Claim counts are the number of unique JCNs for the year and bill type.

Table number Table name
Table 2.2: Number Of Claims With Medical Bills By Date Of Injury / Bill Type

Source: WCIS Medical Bill Payment Database as of June 2020

Table 2.3 shows the count of bills by date of injury and bill type. Bills reported in HCFA/CMS 1500 are professional bills, those reported in UB92/04 are institutional bills, those reported in ADA Dental Claim Forms are dental bills, those reported in NCDP Workers' Compensation/Property & Casualty Universal Claim Form are dental bills while disputed bills with lump sum payments or settlements are reported as lien bills.

Table number Table name
Table 2.3: Number Of Medical Bills By Date Of Injury / Bill Type

Source: WCIS Medical Bill Payment Database as of June 2020

Medical billing reports, tables and papers

March 2021